Organization
ELITE PAIN MANAGEMENT AND MONITORING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALOK KUSHWAHA MD (PHYSICIAN)
(817) 581-7246
Entity
Organization
Contact information
Practice address
6805 NE LOOP 820, SUITE 408, FORT WORTH, TX 76180-6687
(817) 581-7246
(817) 581-7248
Mailing address
6805 NE LOOP 820, SUITE 408, FORT WORTH, TX 76180-6687
(817) 581-7246
(817) 581-7248
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K1232
TX
208VP0014X
Interventional Pain Medicine Physician
Q1455
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159213103
—
TX
Enumeration date
10/21/2016
Last updated
10/21/2016
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