=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699303917
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALI F AHMED MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2020
-----------------------------------------------------
Last Update Date | 07/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 820 E REDD RD BLDG B
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79912-7275
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-581-0712
-----------------------------------------------------
Fax | 915-533-8680
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 12793
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79913-0793
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-581-0712
-----------------------------------------------------
Fax | 915-213-2494
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | V2426
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------