Healthcare Provider Details
I. General information
NPI: 1720180870
Provider Name (Legal Business Name): ASMA NURI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/01/2006
Last Update Date: 10/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2901 MONTOPOLIS DRIVE
AUSTIN TX
78741
US
IV. Provider business mailing address
2901 MONTOPOLIS DR
AUSTIN TX
78741-6411
US
V. Phone/Fax
- Phone: 254-743-0135
- Fax:
- Phone: 512-389-6727
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | K9141 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: