Provider Demographics
NPI:1639669872
Name:KOH, EZRA YUJIN (MD)
Entity Type:Individual
Prefix:
First Name:EZRA
Middle Name:YUJIN
Last Name:KOH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2850
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1540
Mailing Address - Country:US
Mailing Address - Phone:713-486-5100
Mailing Address - Fax:713-512-7200
Practice Address - Street 1:6400 FANNIN ST STE 2850
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1540
Practice Address - Country:US
Practice Address - Phone:713-486-5100
Practice Address - Fax:713-512-7200
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program