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General NPI Number Information
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NPI Number | 1609024108
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Entity Type | Organization
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Legal Business Name | M & M SOUTH AT CLINICA SANTA MARIA, LLP
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Dates
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Enumeration Date | 09/09/2008
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 1474 W PRICE RD # 602
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City | BROWNSVILLE
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State | TX
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Zip | 78520-8687
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Country | US
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Telephone | 956-465-1193
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 SOUTHMOST RD FL 2
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City | BROWNSVILLE
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State | TX
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Zip | 78521-4863
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Country | US
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Telephone | 956-465-1193
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Fax |
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Authorized Official
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Title or Position | MD/PARTNER
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Name | MIR S. ALI
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Credential | MD
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Telephone | 956-465-1193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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