Provider Demographics
NPI:1255505194
Name:BARUA, ALAK (LACMBBSMS)
Entity Type:Individual
Prefix:DR
First Name:ALAK
Middle Name:
Last Name:BARUA
Suffix:
Gender:M
Credentials:LACMBBSMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1041
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-5400
Mailing Address - Country:US
Mailing Address - Phone:972-217-6759
Mailing Address - Fax:972-932-8736
Practice Address - Street 1:874 W HIGHWAY 243 STE 102-103
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1861
Practice Address - Country:US
Practice Address - Phone:972-217-6759
Practice Address - Fax:972-932-8736
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00418171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist