Healthcare Provider Details

I. General information

NPI: 1548897705
Provider Name (Legal Business Name): JOSHUA KOVOOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 08/11/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 RESEARCH BLVD STE LL2
AUSTIN TX
78759-5200
US

IV. Provider business mailing address

11111 RESEARCH BLVD STE LL2
AUSTIN TX
78759-5200
US

V. Phone/Fax

Practice location:
  • Phone: 512-518-4673
  • Fax: 512-334-2702
Mailing address:
  • Phone: 512-518-4673
  • Fax: 512-334-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberV5095
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: