Basic Information
| Provider Information | |||||||||
| NPI: | 1457626947 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | ALI | ||||||||
| FirstName: | NUSRAT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20320 NORTHWEST FWY | ||||||||
| Address2: | SUITE 900 | ||||||||
| City: | JERSEY VILLAGE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770655641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2814537224 | ||||||||
| FaxNumber: | 2814402020 | ||||||||
| Practice Location | |||||||||
| Address1: | 7202 BORDACE CT | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773791602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818751800 | ||||||||
| FaxNumber: | 2814402020 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/15/2012 | ||||||||
| LastUpdateDate: | 04/09/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1207330 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.