MEDICARE: PULIN KOTHARI 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	207ZC0500X	Cytopathology Physician	K2942	TX
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	K2942	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	220033075	OTHER	TX	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1730184136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PULIN KOTHARI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 4701
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77210-4701
Country	:	US
Telephone Number	:	800-288-8325
Fax Number	:

Provider Business Practice Location Address
First Line	:	6565 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2703
Country	:	US
Telephone Number	:	713-394-6450
Fax Number	:

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	03/03/2025

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