1528160132 NPI number — KATHLEEN C KOBASHI MD

Table of content: KATHLEEN C KOBASHI MD (NPI 1528160132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528160132 NPI number — KATHLEEN C KOBASHI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOBASHI
Provider First Name:
KATHLEEN
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528160132
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6560 FANNIN ST STE 2100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-2769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-441-6455
Provider Business Mailing Address Fax Number:
713-441-6463

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6560 FANNIN ST STE 2100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-2769
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-441-6455
Provider Business Practice Location Address Fax Number:
713-441-6463
Provider Enumeration Date:
09/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2088F0040X , with the licence number:  T3983 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208800000X , with the licence number: T3983 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0039595 . This is a "LABOR & INDUSTRY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 340017383 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8249955 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: KO7561 . This is a "BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: NPI . This is a "NP:I" identifier . This identifiers is of the category "OTHER".
  • Identifier: US2168876 . This is a "AETNA/USHC SPECIALIST" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: MD3745 . This is a "ALASKA MEDICAID" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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