Individual
DR. ALI M. KIZILBASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1110 COTTONWOOD LN, SUITE 105, IRVING, TX 75038-6117
(972) 607-2525
(972) 252-8837
Mailing address
1110 COTTONWOOD LN, SUITE 105, IRVING, TX 75038-6117
(972) 607-2525
(972) 252-8837
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K0095
TX
207RC0000X
Cardiovascular Disease Physician
K0095
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
K0095
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105298706
—
TX
05
—
105298707
—
TX
05
—
105298708
—
TX
Enumeration date
07/21/2005
Last updated
06/21/2023
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