MEDICARE: MRS. SAIMA TARIQ ALI APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	AP134030	TX

General Provider Information

NPI Number	:	1134657794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SAIMA TARIQ ALI APRN

Provider Business Mailing Address
First Line	:	2417 SAFFIRE WAY
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75056-6561
Country	:	US
Telephone Number	:	817-715-3774
Fax Number	:

Provider Business Practice Location Address
First Line	:	12200 PARK CENTRAL DR STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75251-2124
Country	:	US
Telephone Number	:	469-804-8323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2017
Last Update Date	:	03/19/2018

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