MEDICARE: AMISHA AHUJA M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207RG0100X	Gastroenterology Physician	U5623	TX

General Provider Information

NPI Number	:	1912431966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMISHA AHUJA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5555
Country	:	US
Telephone Number	:	214-645-6415
Fax Number	:	214-645-6294

Provider Business Practice Location Address
First Line	:	6201 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-4414
Country	:	US
Telephone Number	:	214-633-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2017
Last Update Date	:	10/25/2023

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