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General NPI Number Information
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NPI Number | 1528054046
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Entity Type | Individual
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Provider Name | ALI R SHIRVANI MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4325 N JOSEY LN STE 206
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City | CARROLLTON
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State | TX
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Zip | 75010-4637
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Country | US
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Telephone | 214-915-8515
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Fax | 469-892-2312
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Provider Business Mailing Address
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Address Line | 3600 GASTON AVE SUITE 1205
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City | DALLAS
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State | TX
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Zip | 75246-1812
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Country | US
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Telephone | 214-692-8262
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Fax | 214-696-4190
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | J7848
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License Number State | TX
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