Provider Demographics
NPI:1811325954
Name:COMPREHENSIVE INJURY TREATMENT SERVICES PLLC
Entity type:Organization
Organization Name:COMPREHENSIVE INJURY TREATMENT SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMEED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:254-899-2225
Mailing Address - Street 1:1602 W AVENUE A
Mailing Address - Street 2:STE B
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-4080
Mailing Address - Country:US
Mailing Address - Phone:254-778-6474
Mailing Address - Fax:254-778-6491
Practice Address - Street 1:1602 W AVENUE A
Practice Address - Street 2:STE B
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-4080
Practice Address - Country:US
Practice Address - Phone:254-778-6474
Practice Address - Fax:254-778-6491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP16912083P0500X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX332990Medicare PIN