Basic Information
| Provider Information | |||||||||
| NPI: | 1639308406 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KOHLI | ||||||||
| FirstName: | PARMISH | ||||||||
| MiddleName: | LALIT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4458 MEDICAL DR STE 205 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782293748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106141515 | ||||||||
| FaxNumber: | 2106156904 | ||||||||
| Practice Location | |||||||||
| Address1: | 4458 MEDICAL DR STE 205 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2106141515 | ||||||||
| FaxNumber: | 2106156904 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2009 | ||||||||
| LastUpdateDate: | 01/03/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | Q1651 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | Q1651 | 01 | TX | TEXAS LICENSE | OTHER |