Physician Compare National (NPI:1164683249)

HEALTHCARE PROVIDER: ERIC KAVOSH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1164683249
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709070469
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101027000711
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KAVOSH
	Individual professional last name
Provider First Name	ERIC
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	ALLERGY/IMMUNOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	5904 CHAPEL HILL RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 103
	Group Practice or individual's line 2 address
City	PLANO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	750935925
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y