Provider Demographics
NPI:1386936532
Name:ALI, JAWAD TAHIR (MD)
Entity type:Individual
Prefix:DR
First Name:JAWAD
Middle Name:TAHIR
Last Name:ALI
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 1:1111 E CESAR CHAVEZ ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-4209
Mailing Address - Country:US
Mailing Address - Phone:512-978-9309
Mailing Address - Fax:
Practice Address - Street 1:5339 N IH 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2557
Practice Address - Country:US
Practice Address - Phone:512-978-8130
Practice Address - Fax:512-324-7399
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6139208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery