Provider Demographics
NPI:1093163651
Name:KOSHTI, DEEPA AJAY (MD)
Entity Type:Individual
Prefix:
First Name:DEEPA
Middle Name:AJAY
Last Name:KOSHTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2058 FANNIN STA N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-4656
Mailing Address - Country:US
Mailing Address - Phone:832-221-7176
Mailing Address - Fax:
Practice Address - Street 1:2201 W HOLCOMBE BLVD STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2096
Practice Address - Country:US
Practice Address - Phone:346-570-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT1126207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology