Provider Demographics
NPI:1407395064
Name:ALKOLA, ALI (DMD, BDS)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:ALKOLA
Suffix:
Gender:
Credentials:DMD, BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10220 MEMORIAL DR APT 77
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3227
Mailing Address - Country:US
Mailing Address - Phone:713-628-7583
Mailing Address - Fax:
Practice Address - Street 1:26321 NORTHWEST FWY STE 700
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5759
Practice Address - Country:US
Practice Address - Phone:281-256-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-15
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32002122300000X
TX320031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist