Provider Demographics
NPI:1316111214
Name:COSCIO, ANGELA (MD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:COSCIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17521 ST LUKES WAY STE 180
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8040
Mailing Address - Country:US
Mailing Address - Phone:936-266-3516
Mailing Address - Fax:
Practice Address - Street 1:17198 ST LUKES WAY STE 200
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8013
Practice Address - Country:US
Practice Address - Phone:936-266-4330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAD3189380-AL20207RH0003X
TXN6847207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217361901Medicaid
TXTXB108937Medicare PIN