Organization Active NPI

Executive Health and Wellness of Texas

  • Internal Medicine Physician
  • Grapevine, TX
National Provider Identifier
1881070977
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K1232 Issued in TX
Legal business name
EXECUTIVE HEALTH AND WELLNESS OF TEXAS
Practice address
1643 Lancaster Dr Ste 201
Grapevine, TX 76051-3593
Phone
(817) 328-0349
Fax
(972) 852-9094
NPI assigned
Jul 31, 2015
Last updated
Jul 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Dr. Alok P Kushwaha, MDNPI 1922039155
Title
Director
Phone
(972) 852-9140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X K1232 TX Primary

Addresses

Primary practice location

1643 Lancaster Dr Ste 201
Grapevine, TX 76051-3593

Mailing address

1643 Lancaster Dr Ste 201
Grapevine, TX 76051-3593
Phone (817) 328-0349

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1881070977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1643 LANCASTER DR STE 201",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513593",
            "telephone_number": "817-328-0349",
            "fax_number": "972-852-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1643 LANCASTER DR STE 201",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513593",
            "telephone_number": "817-328-0349",
            "fax_number": "972-852-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE HEALTH AND WELLNESS OF TEXAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "KUSHWAHA",
        "authorized_official_first_name": "ALOK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "972-852-9140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K1232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.