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Individual

LINDA SUSAN KOUBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
24275 KATY FWY STE 400, KATY, TX 77494-7267
(346) 387-7171
(844) 703-5305
Mailing address
24275 KATY FWY STE 400, KATY, TX 77494-7267
(346) 387-7171
(844) 703-5305

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
432245
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
094087603
TX
01
8Y9247
BCBS PAR PLAN
TX
Enumeration date
12/28/2006
Last updated
03/17/2018
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