Healthcare Provider Details

I. General information

NPI: 1184615452
Provider Name (Legal Business Name): EDWARD ROBERT KOST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 05/03/2023
Certification Date: 05/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 W MARTIN ST
SAN ANTONIO TX
78207-0903
US

IV. Provider business mailing address

7703 FLOYD CURL DR
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 210-358-3582
  • Fax: 210-358-3252
Mailing address:
  • Phone: 210-450-9000
  • Fax: 210-450-4903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberL3720
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberL3720
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: