Provider Demographics
NPI:1992247068
Name:K&M HEALTHCARE SERVICES PLLC
Entity type:Organization
Organization Name:K&M HEALTHCARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALOK
Authorized Official - Middle Name:
Authorized Official - Last Name:KUSHWAHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-510-5150
Mailing Address - Street 1:405 STOCKTON DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-2229
Mailing Address - Country:US
Mailing Address - Phone:682-831-0334
Mailing Address - Fax:
Practice Address - Street 1:1643 LANCASTER DR STE 201
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3593
Practice Address - Country:US
Practice Address - Phone:972-510-5150
Practice Address - Fax:972-852-9094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207R00000X, 208100000X, 207R00000X
TXK1232207RA0201X, 207RB0002X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
No207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty