Provider Demographics
NPI:1386714871
Name:BHURIWALA, ALI AKBAR (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:AKBAR
Last Name:BHURIWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-3816
Mailing Address - Country:US
Mailing Address - Phone:936-436-1786
Mailing Address - Fax:
Practice Address - Street 1:1508 11TH ST
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-3816
Practice Address - Country:US
Practice Address - Phone:936-436-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK-1364207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG31878Medicare UPIN
TX81330NMedicare ID - Type Unspecified