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NPI 1083141360

NPI 1083141360 : ASHWIN SAM KOSHY DO : LYTLE, TX

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General NPI Number Information
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    NPI Number           |    1083141360
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    Entity Type          |    Individual 
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    Provider Name        |    ASHWIN SAM KOSHY DO
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/17/2017
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    Last Update Date     |    06/24/2025
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Provider Practice Location Address
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    Address Line         |    19010 PREIST BLVD 
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    City                 |    LYTLE
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    State                |    TX
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    Zip                  |    78052-3486
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    Country              |    US
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    Telephone            |    830-772-9865
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    Fax                  |    830-772-9821
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Provider Business Mailing Address
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    Address Line         |    310 W OAKLAWN RD 
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    City                 |    PLEASANTON
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    State                |    TX
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    Zip                  |    78064-4033
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    Country              |    US
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    Telephone            |    830-569-8940
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    V4695
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    License Number State |    TX
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