Provider Demographics
NPI:1164284162
Name:JANICE KOSHY MD PLLC
Entity Type:Organization
Organization Name:JANICE KOSHY MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-975-8105
Mailing Address - Street 1:5106 ROYAL SUNSET CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2891
Mailing Address - Country:US
Mailing Address - Phone:832-867-0475
Mailing Address - Fax:
Practice Address - Street 1:5106 ROYAL SUNSET CT
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2891
Practice Address - Country:US
Practice Address - Phone:832-867-0475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX313020501Medicaid