Provider Demographics
NPI:1780979823
Name:DESH, ALOK (ALOK DESH)
Entity type:Individual
Prefix:DR
First Name:ALOK
Middle Name:
Last Name:DESH
Suffix:
Gender:M
Credentials:ALOK DESH
Other - Prefix:DR
Other - First Name:ALOK
Other - Middle Name:D
Other - Last Name:DESHPANDE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4515 SETON CENTER PKWY STE 215
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5785
Mailing Address - Country:US
Mailing Address - Phone:512-324-1864
Mailing Address - Fax:512-419-9016
Practice Address - Street 1:1201 W 38TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1006
Practice Address - Country:US
Practice Address - Phone:512-324-1864
Practice Address - Fax:512-419-9016
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-15470207R00000X
TXP6604207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX353368YLP1OtherMEDICARE SAIMS TRAVIS
TX353368YKXYOtherMEDICARE ARC ROT
TX338692207OtherMEDICAID ARC TRAVIS
TX353368YKXVOtherMEDICARE ARC TRAVIS
TX353368YLP2OtherMEDICARE SAIMS ROT