Provider Demographics
NPI:1114130457
Name:NORTH HOUSTON RENAL CONSULTANTS, P.A.
Entity Type:Organization
Organization Name:NORTH HOUSTON RENAL CONSULTANTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENEAN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-540-8779
Mailing Address - Street 1:19502 MCKAY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5720
Mailing Address - Country:US
Mailing Address - Phone:281-540-8779
Mailing Address - Fax:281-540-8798
Practice Address - Street 1:19502 MCKAY DR STE 200
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5720
Practice Address - Country:US
Practice Address - Phone:281-540-8779
Practice Address - Fax:281-540-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9082207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDC1367OtherPGBA
TX0098JSOtherBCBS
TX167641301OtherAMERIGROUP
TX167641301Medicaid
TX614460423OtherCIGNA
TX=========OtherHUMANA
TX614460423OtherCIGNA
TX=========OtherTRICARE
TX167641301Medicaid
TX=========OtherAHI
TX=========OtherHERITAGE
TX=========OtherMHHNP
TX=========OtherEVERCARE
TX=========OtherWELLCARE
TX167641301OtherAMERIGROUP
TXDC1367OtherPGBA
TX167641301Medicaid