MEDICARE: REMIX MEDICAL, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	2085R0204X	Vascular & Interventional Radiology Physician
3	207RI0200X	Infectious Disease Physician	N6799	TX
4	207LP2900X	Pain Medicine (Anesthesiology) Physician	P4780	TX
5	2085R0202X	Diagnostic Radiology Physician
6	207RN0300X	Nephrology Physician	L2965	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00Q21D	OTHER	TX	BCBS GROUP ID
3	DY0410	OTHER	TX	RR MCR

General Provider Information

NPI Number	:	1891207601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REMIX MEDICAL, PLLC

Provider Business Mailing Address
First Line	:	9450 SW GEMINI DR # 51007
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97008-7105
Country	:	US
Telephone Number	:	713-597-5131
Fax Number	:	713-597-7611

Provider Business Practice Location Address
First Line	:	1724 RICHMOND AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098
Country	:	US
Telephone Number	:	713-597-5131
Fax Number	:	713-597-7611

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. UDAY KHOSLA
Credential	:	MD
Telephone Number	:	713-899-4023

Provider Enumeration Date	:	11/02/2017
Last Update Date	:	01/12/2026

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Directions to “REMIX MEDICAL, PLLC ” Practice Location

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