Individual
DR. ASIF ALI KHAN ANSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 N. TOM GREEN, PERMIAN BASIN KIDNEY CENTER, ODESSA, TX 79761
(432) 279-0905
Mailing address
401 N. TOM GREEN, PERMIAN BASIN KIDNEY CENTER, ODESSA, TX 79761
(432) 279-0905
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
P9295
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
947540926-00
PRIORITYHMO
MI
Enumeration date
08/04/2009
Last updated
08/26/2014
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