Provider Demographics
NPI:1851399067
Name:ALASWAD, BASHAR (MD)
Entity Type:Individual
Prefix:MR
First Name:BASHAR
Middle Name:
Last Name:ALASWAD
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:PO BOX 2183
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-2183
Mailing Address - Country:US
Mailing Address - Phone:409-813-3883
Mailing Address - Fax:409-813-3848
Practice Address - Street 1:740 HOSPITAL DRIVE
Practice Address - Street 2:STE 120
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-4670
Practice Address - Country:US
Practice Address - Phone:409-813-3883
Practice Address - Fax:409-813-3848
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK05972080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX137982801Medicaid
TX137982801Medicaid
F71709Medicare UPIN