Provider Demographics
NPI:1942617204
Name:TEXANS MD HOUSE CALLS MANAGEMENT LLC
Entity Type:Organization
Organization Name:TEXANS MD HOUSE CALLS MANAGEMENT LLC
Other - Org Name:TEXANS MD HOUSE CALLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KOSHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-850-9146
Mailing Address - Street 1:4124 GUS THOMASSON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2226
Mailing Address - Country:US
Mailing Address - Phone:972-850-9146
Mailing Address - Fax:
Practice Address - Street 1:4124 GUS THOMASSON RD
Practice Address - Street 2:SUITE B
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2226
Practice Address - Country:US
Practice Address - Phone:972-850-9146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-18
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4055207QA0505X
TXN7261207R00000X
TXL3473207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX380716Medicare PIN
TX383767ZK7GMedicare PIN
TX404562ZK7GMedicare PIN
TX404541ZK7GMedicare PIN