Basic Information
| Provider Information | |||||||||
| NPI: | 1851949804 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOOMRO | ||||||||
| FirstName: | AILA | ||||||||
| MiddleName: | MUNAWAR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3817 CAMINO DR | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750743445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2145542351 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3600 GASTON AVE STE 550 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752461905 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4698007974 | ||||||||
| FaxNumber: | 2148211193 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2019 | ||||||||
| LastUpdateDate: | 03/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA13341 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.