Provider Demographics
NPI:1922039155
Name:KUSHWAHA, ALOK PRATAP (MD)
Entity type:Individual
Prefix:DR
First Name:ALOK
Middle Name:PRATAP
Last Name:KUSHWAHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 734875
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-4875
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:809 W HARWOOD RD STE 202
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-6233
Practice Address - Country:US
Practice Address - Phone:817-377-0143
Practice Address - Fax:888-750-8159
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1232207RB0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00463037OtherRAILROAD MEDICARE
TX0008REOtherBCBS OF TEXAS
TX159213103Medicaid
TX159213103Medicaid
TXP00463037OtherRAILROAD MEDICARE