Ayesha Kanwal DO PLLC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

Q2313 Issued in TX

Legal business name

AYESHA KANWAL DO PLLC

Practice address

4819 Riveroaks Blvd
Fort Worth, TX 76114-3098

Phone

(817) 626-9744

Fax

(817) 626-9962

NPI assigned

Apr 27, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ayesha Kanwal, DO

Title

Authorized/Owner

Phone

(817) 703-8671

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1659806511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 RIVEROAKS BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761144656",
            "telephone_number": "817-626-9744",
            "fax_number": "817-626-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4819 RIVEROAKS BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761143098",
            "telephone_number": "817-626-9744",
            "fax_number": "817-626-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AYESHA KANWAL DO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "KANWAL",
        "authorized_official_first_name": "AYESHA",
        "authorized_official_title_or_position": "AUTHORIZED/OWNER",
        "authorized_official_telephone_number": "817-703-8671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "TX",
            "license": "Q2313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Axonos Medical Group PLLC
• Dan Alan Axthelm, M.D.
• Julie Kay Ayala, LPC
• Tania Ayala, APRN-CNP
• David Ayaram, MD
• Nanci H. Aylor-Wilkerson, ARNP/CRNA
• Jeremy Michael Aymard, MD
• Babajide Yekin Ayodeji, LVN
• Martins Ajiboye Ayoola, MD
• Rashonda Ayro, LMSW

• Rheumatology Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Rheumatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.