Provider Demographics
NPI:1861600249
Name:NOBLE PRIMARY CARE ASSOCIATES PA
Entity type:Organization
Organization Name:NOBLE PRIMARY CARE ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-313-3900
Mailing Address - Street 1:2205 WILLIAMS TRACE BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4443
Mailing Address - Country:US
Mailing Address - Phone:281-313-3900
Mailing Address - Fax:281-313-3901
Practice Address - Street 1:2205 WILLIAMS TRACE BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4443
Practice Address - Country:US
Practice Address - Phone:281-313-3900
Practice Address - Fax:281-313-3901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6796261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00423ROtherBLUE CROSS BLUE SHIELD
TX145965301Medicaid
TX145965303Medicaid