Provider Demographics
NPI:1114934833
Name:KOTHARI, USHA D (MD)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:D
Last Name:KOTHARI
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:PO BOX 230138
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77223-0138
Mailing Address - Country:US
Mailing Address - Phone:713-921-9211
Mailing Address - Fax:713-921-7955
Practice Address - Street 1:7040 LAWNDALE ST
Practice Address - Street 2:STE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77023
Practice Address - Country:US
Practice Address - Phone:713-921-9211
Practice Address - Fax:713-921-7955
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5611208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
005DROtherBCBS
TX00574GMedicare ID - Type Unspecified
005DROtherBCBS