Provider Demographics
NPI:1780689398
Name:KHOSLA, UDAY (MD)
Entity Type:Individual
Prefix:
First Name:UDAY
Middle Name:
Last Name:KHOSLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:337 GARDEN OAKS BLVD # 51007
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-5501
Mailing Address - Country:US
Mailing Address - Phone:713-352-0903
Mailing Address - Fax:855-474-9087
Practice Address - Street 1:1724 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3604
Practice Address - Country:US
Practice Address - Phone:713-352-0903
Practice Address - Fax:855-464-9087
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL2965207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H9905OtherBC/BS
TXI18401Medicare UPIN
TX8F6645Medicare PIN