Provider Demographics
NPI:1376651687
Name:PHALAK, ASHOK H (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:H
Last Name:PHALAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15314 BLACK FALLS LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-1290
Mailing Address - Country:US
Mailing Address - Phone:281-461-5356
Mailing Address - Fax:
Practice Address - Street 1:15314 BLACK FALLS LANE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-1290
Practice Address - Country:US
Practice Address - Phone:281-561-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7882207P00000X
OK11416207P00000X
CAA33231207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
784451Medicare UPIN