Individual
MIR S ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3354 INTERNATIONAL BLVD, BROWNSVILLE, TX 78521-3226
(956) 548-6666
(956) 548-6667
Mailing address
1710 BRIARWYCK DR, BROWNSVILLE, TX 78520-9262
(956) 350-6144
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K3668
TX
2080A0000X
Pediatric Adolescent Medicine Physician
K3668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104844903
—
TX
Enumeration date
05/06/2006
Last updated
10/16/2008
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