Mir S Ali, MD

Individual provider Active NPI Pediatrics Physician · Brownsville, TX

NPI 1851340129 · NPPES record last updated Oct 16, 2008

Key facts

NPI
1851340129
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
K3668 (TX)
Practice address
3354 International Blvd
Brownsville, TX 78521-3226
Phone
(956) 548-6666
Fax
(956) 548-6667
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20060404000261 TX Practitioner - Pediatric Medicine 0244248193 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K3668TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
M & M Pediatrics, PLLC Pediatrics Current
since May 1, 2012
Accepting new patients
M & M North, LLP Pediatrics Past Accepting new patients
M & M South at Clinica Santa Maria, LLP Pediatrics Past Accepting new patients

Locations

3354 International Blvd
Brownsville, TX 78521
Phone (956) 548-6666

1474 W Price Rd
#602
Brownsville, TX 78520
Phone (956) 465-1193

1424 W Price Rd
#602
Brownsville, TX 78520

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K3668 TX Yes
Pediatric Adolescent Medicine Physician 2080A0000X K3668 TX

Addresses

Primary practice location

3354 International Blvd
Brownsville, TX 78521-3226

Mailing address

1710 Briarwyck Dr
Brownsville, TX 78520-9262
Phone (956) 350-6144

Other identifiers

IdentifierTypeStateIssuer
104844903MedicaidTX

Other providers in Brownsville, TX

All providers in Brownsville, TX · Pediatrics Physician in Texas

Sources for this page

Verify at the official NPI Registry.