Basic Information
| Provider Information | |||||||||
| NPI: | 1144478389 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MONA ALVI MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2600 E SOUTHLAKE BLVD | ||||||||
| Address2: | SUITE 120-149 | ||||||||
| City: | SOUTHLAKE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760926634 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 5560 MESA SPRINGS DR | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761232120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8172924600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2008 | ||||||||
| LastUpdateDate: | 02/24/2022 | ||||||||
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| AuthorizedOfficialLastName: | ALVI | ||||||||
| AuthorizedOfficialFirstName: | MONA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 8172924600 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.