Provider Demographics
NPI:1831103720
Name:KOTECHA, NILESH N (MD)
Entity Type:Individual
Prefix:MR
First Name:NILESH
Middle Name:N
Last Name:KOTECHA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14 LYRIC ARBOR CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-6640
Mailing Address - Country:US
Mailing Address - Phone:734-709-6477
Mailing Address - Fax:888-330-6220
Practice Address - Street 1:25510 INTERSTATE 45 STE 101
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1375
Practice Address - Country:US
Practice Address - Phone:832-916-2707
Practice Address - Fax:832-924-3358
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ5600207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX323758YWLRMedicare PIN
H36178Medicare UPIN