MEDICARE: EUGENE J KOAY M.D., PH.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	2085R0001X	Radiation Oncology Physician	BP20038551	TX

General Provider Information

NPI Number	:	1699011924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE J KOAY M.D., PH.D.

Provider Business Mailing Address
First Line	:	1220 HOLCOMBE BLVD
Second Line	:	MS 97
City	:	HOUSTON
State	:	TX
Zip	:	77030-4004
Country	:	US
Telephone Number	:	817-805-2839
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 HOLCOMBE BLVD
Second Line	:	MS 97
City	:	HOUSTON
State	:	TX
Zip	:	77030-4004
Country	:	US
Telephone Number	:	817-805-2839
Fax Number	:

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

Provider Enumeration Date	:	12/13/2012
Last Update Date	:	12/13/2012

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