Provider Demographics
NPI:1568002624
Name:KOCH, REBECCA MCEWEN (PHARMD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:MCEWEN
Last Name:KOCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18300 HOUSTON METHODIST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-6302
Mailing Address - Country:US
Mailing Address - Phone:325-232-1478
Mailing Address - Fax:
Practice Address - Street 1:18300 HOUSTON METHODIST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-6302
Practice Address - Country:US
Practice Address - Phone:281-333-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX53158183500000X, 1835C0205X, 1835E0208X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835C0205XPharmacy Service ProvidersPharmacistCritical Care
No1835E0208XPharmacy Service ProvidersPharmacistEmergency Medicine