Provider Demographics
NPI:1740289297
Name:NABULSI, SARI ALI (MD)
Entity type:Individual
Prefix:DR
First Name:SARI
Middle Name:ALI
Last Name:NABULSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 W WADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5055
Mailing Address - Country:US
Mailing Address - Phone:432-699-2636
Mailing Address - Fax:432-699-4134
Practice Address - Street 1:5801 W WADLEY AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-5055
Practice Address - Country:US
Practice Address - Phone:432-699-2636
Practice Address - Fax:432-699-4134
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6175208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0473050-03Medicaid
TX2313762OtherCIGNA
TXH1844426OtherUNITED HEALTHCARE
TX5135595OtherAETNA
TX122477OtherCHIPS
TX8G9660OtherBLUE CROSS BLUE SHIELD
TX047305003Medicaid
TX0473050-03Medicaid