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NPI Code Detail

MEDICARE: UDAY KHOSLA MD

MEDICARE: UDAY KHOSLA MD
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
1207RN0300XNephrology PhysicianL2965TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18H9905OTHERTXBC/BS

General Provider Information

NPI Number : 1780689398
Entity Type Code : Individual
Provider Name (Legal Business Name) : UDAY KHOSLA MD
Provider Business Mailing Address
First Line : 337 GARDEN OAKS BLVD # 51007
Second Line :
City : HOUSTON
State : TX
Zip : 77018-5501
Country : US
Telephone Number : 713-352-0903
Fax Number : 855-474-9087
Provider Business Practice Location Address
First Line : 1724 RICHMOND AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3604
Country : US
Telephone Number : 713-352-0903
Fax Number : 855-464-9087
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 03/17/2018

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