Provider Demographics
NPI:1538397583
Name:KOSHY, REGINA (MD)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:
Last Name:KOSHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6210 E HWY 290 STE 420
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1142
Mailing Address - Country:US
Mailing Address - Phone:512-338-3826
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:6818 AUSTIN CENTER BLVD STE 205
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3100
Practice Address - Country:US
Practice Address - Phone:512-344-0450
Practice Address - Fax:512-406-7321
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXQ2318207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX408267901Medicaid
TX408267902Medicaid