MEDICARE: ASHOK H PHALAK 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	207P00000X	Emergency Medicine Physician	F7882	TX
2	207P00000X	Emergency Medicine Physician	11416	OK
3	207P00000X	Emergency Medicine Physician	A33231	CA

General Provider Information

NPI Number	:	1376651687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHOK H PHALAK M.D.

Provider Business Mailing Address
First Line	:	15314 BLACK FALLS LN
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-1290
Country	:	US
Telephone Number	:	281-461-5356
Fax Number	:

Provider Business Practice Location Address
First Line	:	15314 BLACK FALLS LANE
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-1290
Country	:	US
Telephone Number	:	281-561-5356
Fax Number	:

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

Provider Enumeration Date	:	08/27/2006
Last Update Date	:	07/08/2007

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