Provider Demographics
NPI:1770839631
Name:SHAMS-HAKIMI, ALI (DPM)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:SHAMS-HAKIMI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 EXECUTIVE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-1762
Mailing Address - Country:US
Mailing Address - Phone:281-249-7100
Mailing Address - Fax:281-249-7365
Practice Address - Street 1:14502 CYPRESS MILL PLACE BLVD # 300
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7299
Practice Address - Country:US
Practice Address - Phone:832-899-4708
Practice Address - Fax:832-899-4709
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2133213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1245983618Medicaid