Provider Demographics
NPI:1003958323
Name:KIDNEY CENTER OF NORTH HOUSTON
Entity Type:Organization
Organization Name:KIDNEY CENTER OF NORTH HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUJAUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BHURIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-357-1300
Mailing Address - Street 1:27721 TOMBALL PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-6411
Mailing Address - Country:US
Mailing Address - Phone:281-357-1300
Mailing Address - Fax:281-357-1309
Practice Address - Street 1:27721 TOMBALL PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6411
Practice Address - Country:US
Practice Address - Phone:281-357-1300
Practice Address - Fax:281-357-1309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8009207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142418601Medicaid
TX8A6910OtherBLUE CROSS BLUE SHIELD
TXG37505Medicare UPIN
TX00247RMedicare PIN