Basic Information
| Provider Information | |||||||||
| NPI: | 1538475934 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICKY AHLUWALIA MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2521 TIMBER COVE LN | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750938832 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 2521 TIMBER COVE LN | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750938832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726687460 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2010 | ||||||||
| LastUpdateDate: | 08/23/2010 | ||||||||
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| AuthorizedOfficialLastName: | AHLUWALIA | ||||||||
| AuthorizedOfficialFirstName: | MICKY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9726687460 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | J0418 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.