Healthcare Provider Details

I. General information

NPI: 1922039155
Provider Name (Legal Business Name): ALOK PRATAP KUSHWAHA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 W HARWOOD RD STE 202
HURST TX
76054-6233
US

IV. Provider business mailing address

PO BOX 734875
DALLAS TX
75373-4875
US

V. Phone/Fax

Practice location:
  • Phone: 817-377-0143
  • Fax: 888-750-8159
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License NumberK1232
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK1232
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: