Provider Demographics
NPI:1952349920
Name:POPATIA, AMIRALI S (MD)
Entity Type:Individual
Prefix:
First Name:AMIRALI
Middle Name:S
Last Name:POPATIA
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 1:1603 MAIN ST
Mailing Address - Street 2:200
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3226
Mailing Address - Country:US
Mailing Address - Phone:281-344-2273
Mailing Address - Fax:281-344-8007
Practice Address - Street 1:1603 MAIN ST
Practice Address - Street 2:200
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3226
Practice Address - Country:US
Practice Address - Phone:281-344-2273
Practice Address - Fax:281-344-8007
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1356174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF67747Medicare UPIN
TX8D7453Medicare ID - Type UnspecifiedPROVIDER NUMBER