Healthcare Provider Details
I. General information
NPI: 1316809080
Provider Name (Legal Business Name): KOVO CLINICS TX, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2504 SACRAMENTO ST APT 6
SAN FRANCISCO CA
94115-2234
US
IV. Provider business mailing address
2504 SACRAMENTO ST APT 6
SAN FRANCISCO CA
94115-2234
US
V. Phone/Fax
- Phone: 832-956-0609
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YURY
YAKUBCHYK
Title or Position: PRESIDENT
Credential: MD
Phone: 832-956-0609