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General NPI Number Information
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NPI Number | 1306084793
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Entity Type | Organization
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Legal Business Name | USHA WALIA MD PA
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Dates
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Enumeration Date | 01/23/2009
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 2719 NORTHRIDGE DR STE 107
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City | BEDFORD
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State | TX
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Zip | 76021-4191
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Country | US
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Telephone | 817-803-3610
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Fax |
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Provider Business Mailing Address
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Address Line | 2719 NORTHRIDGE DR STE 107
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City | BEDFORD
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State | TX
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Zip | 76021-4191
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Country | US
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Telephone | 817-803-3610
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. USHA WALIA
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Credential | MD
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Telephone | 817-803-3610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | J0719
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License Number State | TX
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