Individual
DR. ATOOSA KOUROSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1170 N CARROLL AVE, SOUTHLAKE, TX 76092-5306
(214) 702-6550
(214) 894-4182
Mailing address
1170 N CARROLL AVE, SOUTHLAKE, TX 76092-5306
(214) 702-6550
(214) 894-4182
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
MD00044424
WA
208000000X
Pediatrics Physician
MD00044424
WA
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
MD00044424
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01733874
RR MEDICARE WVH
WA
Enumeration date
10/13/2006
Last updated
11/17/2022
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