Provider Demographics
NPI:1982871695
Name:KOSHY, PRASHANT GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:PRASHANT
Middle Name:GEORGE
Last Name:KOSHY
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 1:10837 KATY FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-2212
Mailing Address - Country:US
Mailing Address - Phone:713-468-2122
Mailing Address - Fax:713-468-2289
Practice Address - Street 1:10837 KATY FWY STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079
Practice Address - Country:US
Practice Address - Phone:713-468-2122
Practice Address - Fax:713-468-2289
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9886207RE0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285141202Medicaid
TX8JG007OtherBCBS