| Tara Medical | |
|
25140 Kingsland Blvd Ste 200 Katy TX 77494-8472 | |
| (346) 536-3935 | |
| (346) 206-0127 |
| Full Name | Tara Medical |
|---|---|
| Speciality | Internal Medicine |
| Location | 25140 Kingsland Blvd Ste 200, Katy, Texas |
| Authorized Official Name and Position | Janice John Koshy (OWNER) |
| Authorized Official Contact | 3465363935 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Medical 5106 Royal Sunset Ct Katy TX 77493-2891 Ph: (832) 867-0475 | Tara Medical 25140 Kingsland Blvd Ste 200 Katy TX 77494-8472 Ph: (346) 536-3935 |
| NPI Number | 1164284162 |
|---|---|
| Provider Enumeration Date | 01/25/2024 |
| Last Update Date | 06/24/2026 |
| Certification Date | 06/24/2026 |
| Medicare PECOS PAC ID | 4183069818 |
|---|---|
| Medicare Enrollment ID | O20240304001753 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164284162 | NPI | - | NPPES |
| 313020501 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | () | Primary |
| Provider Name | Janice Koshy |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1023336286 PECOS PAC ID: 3274849047 Enrollment ID: I20150825004848 |
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