MEDICARE: ALPESH D. DESAI, D.O. P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	M1072	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DF0888	OTHER		RAILROAD MEDICARE

General Provider Information

NPI Number	:	1124078985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPESH D. DESAI, D.O. P.A.

Provider Business Mailing Address
First Line	:	2120 ASHLAND ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008
Country	:	US
Telephone Number	:	713-864-2659
Fax Number	:

Provider Business Practice Location Address
First Line	:	2120 ASHLAND ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008
Country	:	US
Telephone Number	:	713-864-2659
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. ALPESH D DESAI
Credential	:	D.O.
Telephone Number	:	713-864-2659

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	01/01/2008

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