MEDICARE: RAHUL S KOUSHIK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	M2681	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00336530	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275518755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAHUL S KOUSHIK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 15066
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-8266
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3327 RESEARCH PLZ
Second Line	:	SUITE 315
City	:	SAN ANTONIO
State	:	TX
Zip	:	78235-5155
Country	:	US
Telephone Number	:	210-268-2477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	10/21/2014

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