Individual ProviderPrithviraj BoseInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1515 Holcombe Blvd, Houston, TX 77030-4000(713) 792-6161(713) 792-2991PECOS EnrollmentBased on the most recent information from CMS, provider Prithviraj Bose is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:26 AM.Profile DetailsProvider ID1154449114Provider TypeIndividualFull NameBose, PrithvirajTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date3/27/2007Last Updated3/16/2015Contact InformationPractice LocationPractice Address1515 Holcombe Blvd, Houston, TX 77030-4000Phone(713) 792-6161Fax(713) 794-4534Mailing LocationMailing AddressPO Box 4439, Houston, TX 77210-4439Phone(713) 792-2991Fax(713) 794-4534Provider TaxonomiesCodeDescriptionLicenseCode207RH0003XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense0101246281VirginiaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4301085367MichiganCode207RH0003XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense25431OklahomaCode207RH0003XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicenseQ2742Texas