Provider Demographics
NPI:1083031421
Name:URSANI, MOHAMMAD ALI (MD)
Entity type:Individual
Prefix:MR
First Name:MOHAMMAD
Middle Name:ALI
Last Name:URSANI
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58538
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-8538
Mailing Address - Country:US
Mailing Address - Phone:346-209-3581
Mailing Address - Fax:346-207-0885
Practice Address - Street 1:17450 ST LUKES WAY STE 250
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-8045
Practice Address - Country:US
Practice Address - Phone:346-230-2442
Practice Address - Fax:346-207-0890
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7494207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX371422201Medicaid