# M. EBADAT ALI, MD, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568785186
- **Authorized official:** DR. MOHAMED EBADAT ALI MD (PRESIDENT)
- **Authorized official phone:** (817) 336-8773

## Contact information

- **Practice address:** 1650 W ROSEDALE ST, SUITE 203, FORT WORTH, TX 76104-7400
- **Practice address phone:** (817) 336-8773
- **Mailing address:** 1650 W ROSEDALE ST, SUITE 203, FORT WORTH, TX 76104-7400
- **Mailing address phone:** (817) 336-8773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | E2970 | TX | Yes |

## Other

- **Enumeration date:** 03/10/2010
- **Last updated:** 03/10/2010