Provider Demographics
NPI:1427823731
Name:KOSHY, ESTHER MARY
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:MARY
Last Name:KOSHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 KINGS FORT PKWY
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-3575
Mailing Address - Country:US
Mailing Address - Phone:469-595-7076
Mailing Address - Fax:
Practice Address - Street 1:300 KINGS FORT PKWY
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-3575
Practice Address - Country:US
Practice Address - Phone:469-595-7076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist