MEDICARE: ASRA ALI M.D.

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	207N00000X	Dermatology Physician	K5442	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8MV745	OTHER	TX	BCBS TX

General Provider Information

NPI Number	:	1144260217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASRA ALI M.D.

Provider Business Mailing Address
First Line	:	9225 KATY FWY STE 404
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1531
Country	:	US
Telephone Number	:	832-572-5533
Fax Number	:	832-975-0336

Provider Business Practice Location Address
First Line	:	9225 KATY FWY STE 404
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1531
Country	:	US
Telephone Number	:	832-572-5533
Fax Number	:	832-975-0336

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/18/2020

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