Individual
DR. ALI KHALIFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 E DAWSON ST # 2, TYLER, TX 75701-2036
(903) 531-4500
Mailing address
800 E DAWSON ST # 2, TYLER, TX 75701-2036
(190) 353-1450
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
Q8084
TX
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Q8084
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
587381ZGX7
MEDICARE
TX
01
—
75-2616977-042
TRICARE
TX
01
—
P01878844
MEDICARE RAIL ROAD
TX
Enumeration date
03/28/2012
Last updated
06/17/2024
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