NPIMap

Organization Active NPI

Eric R. Koch DDS PC

  • General Practice Dentistry
  • Jasper, TX
National Provider Identifier
1003986043
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15428 Issued in TX
Legal business name
ERIC R. KOCH DDS PC
Practice address
211 E. Houston St
Jasper, TX 75951-4407
Phone
(409) 384-5438
Fax
(409) 384-6082
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eric Randolph Koch, DDSNPI 1598766339
Title
Owner
Phone
(409) 384-5438

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 15428 TX Primary

Addresses

Primary practice location

211 E. Houston St
Jasper, TX 75951-4407

Mailing address

211 E. Houston St
Jasper, TX 75951-4407
Phone (409) 384-5438

National Provider Directory

National Provider Directory

Locations

211 E Houston St
Jasper, TX 75951
Phone (409) 384-5438

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003986043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E. HOUSTON ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514407",
            "telephone_number": "409-384-5438",
            "fax_number": "409-384-6082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E. HOUSTON ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514407",
            "telephone_number": "409-384-5438",
            "fax_number": "409-384-6082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC R. KOCH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "RANDOLPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-384-5438",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "15428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.