Provider Demographics
NPI:1083141360
Name:KOSHY, ASHWIN SAM (DO)
Entity type:Individual
Prefix:
First Name:ASHWIN
Middle Name:SAM
Last Name:KOSHY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 W OAKLAWN RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4033
Mailing Address - Country:US
Mailing Address - Phone:830-569-8940
Mailing Address - Fax:
Practice Address - Street 1:19010 PREIST BLVD
Practice Address - Street 2:
Practice Address - City:LYTLE
Practice Address - State:TX
Practice Address - Zip Code:78052-3486
Practice Address - Country:US
Practice Address - Phone:830-772-9865
Practice Address - Fax:830-772-9821
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV4695207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine