Provider Demographics
NPI:1528160132
Name:KOBASHI, KATHLEEN C (MD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:C
Last Name:KOBASHI
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 1:6560 FANNIN ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2769
Mailing Address - Country:US
Mailing Address - Phone:713-441-6455
Mailing Address - Fax:713-441-6463
Practice Address - Street 1:6560 FANNIN ST STE 2100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2769
Practice Address - Country:US
Practice Address - Phone:713-441-6455
Practice Address - Fax:713-441-6463
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT39832088F0040X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0039595OtherLABOR & INDUSTRY
340017383OtherRAILROAD MEDICARE
WA8249955Medicaid
WAKO7561OtherBLUE SHIELD
NPIOtherNP:I
WAUS2168876OtherAETNA/USHC SPECIALIST
WAMD3745OtherALASKA MEDICAID
WA8249955Medicaid
WAAB13006Medicare PIN