Provider Demographics
NPI:1821080714
Name:ALKHUSH, AHMAD-RABIA (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMAD-RABIA
Middle Name:
Last Name:ALKHUSH
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 1:23920 KATY FWY
Mailing Address - Street 2:STE 330
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0899
Mailing Address - Country:US
Mailing Address - Phone:281-492-7062
Mailing Address - Fax:
Practice Address - Street 1:705 S FRY RD
Practice Address - Street 2:STE 225
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2251
Practice Address - Country:US
Practice Address - Phone:281-492-7062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2019-09-23
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
TXL2086207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151704704Medicaid
TX151704704Medicaid
TX8842B6Medicare PIN