MEDICARE: ALI R SHIRVANI MD

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	208800000X	Urology Physician	J7848	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	575375YNED	OTHER	TX	MEDICARE DALLAS
2	575372YND4	OTHER	TX	MEDICARE 99
3	575372YNEC	OTHER	TX	MEDICARE - TARRANT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528054046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALI R SHIRVANI MD

Provider Business Mailing Address
First Line	:	3600 GASTON AVE
Second Line	:	SUITE 1205
City	:	DALLAS
State	:	TX
Zip	:	75246-1812
Country	:	US
Telephone Number	:	214-692-8262
Fax Number	:	214-696-4190

Provider Business Practice Location Address
First Line	:	4325 N JOSEY LN STE 206
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4637
Country	:	US
Telephone Number	:	214-915-8515
Fax Number	:	469-892-2312

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	03/17/2018

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Directions to “ ALI R SHIRVANI MD” Practice Location

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