Healthcare Provider Details

I. General information

NPI: 1942854831
Provider Name (Legal Business Name): MIR M. ALI, MD ADVANCED WOUND CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2019
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27700 NORTHWEST FWY STE 170
CYPRESS TX
77433-8105
US

IV. Provider business mailing address

514 CRESTWOOD DR
HOUSTON TX
77007-5092
US

V. Phone/Fax

Practice location:
  • Phone: 832-912-3791
  • Fax:
Mailing address:
  • Phone: 832-912-3791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MIR M ALI
Title or Position: OWNER/PROVIDER
Credential: MD
Phone: 832-912-3791