1124492533 NPI number — RACHEL LISA SAMUEL-KOSHY L.C.S.W.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124492533 NPI number — RACHEL LISA SAMUEL-KOSHY L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAMUEL-KOSHY
Provider First Name:
RACHEL
Provider Middle Name:
LISA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAMUEL
Provider Other First Name:
RACHEL
Provider Other Middle Name:
LISA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.C.S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124492533
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24646 KINGSLAND BLVD.
Provider Second Line Business Mailing Address:
CINCO RANCH BEHAVIORAL HEALTH
Provider Business Mailing Address City Name:
KATY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77494
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-665-7346
Provider Business Mailing Address Fax Number:
281-674-8422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24646 KINGSLAND BLVD.
Provider Second Line Business Practice Location Address:
CINCO RANCH BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
KATY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-665-7346
Provider Business Practice Location Address Fax Number:
281-674-8422
Provider Enumeration Date:
11/23/2015

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: 1041C0700X , with the licence number:  29657 , 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)





Copyright © 2007-2025 www.npivalidator.com