Provider Demographics
NPI:1871500520
Name:BRISCOE, KAREN WASH (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:WASH
Last Name:BRISCOE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:RIKER
Other - Last Name:WASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 12507
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-0507
Mailing Address - Country:US
Mailing Address - Phone:210-704-2467
Mailing Address - Fax:210-704-4675
Practice Address - Street 1:333 N SANTA ROSA ST
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3108
Practice Address - Country:US
Practice Address - Phone:210-704-2467
Practice Address - Fax:210-704-4675
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL62112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00772148OtherMEDICARE RAILROAD
TX156641608Medicaid
H79370Medicare UPIN
TX8L16216Medicare PIN