Provider Demographics
NPI:1437104429
Name:NEPHROLOGY DIALYSIS AND TRANSPLANTATION ASSOCIATES PA
Entity Type:Organization
Organization Name:NEPHROLOGY DIALYSIS AND TRANSPLANTATION ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NASSAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-790-9080
Mailing Address - Street 1:6560 FANNIN ST STE 1824
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2735
Mailing Address - Country:US
Mailing Address - Phone:713-790-9080
Mailing Address - Fax:713-335-4281
Practice Address - Street 1:6560 FANNIN ST STE 1824
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2735
Practice Address - Country:US
Practice Address - Phone:713-790-9080
Practice Address - Fax:713-335-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXC8459207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081304001Medicaid
TXCH4817OtherMEDICARE RAILROAD
TX00875NOtherBLUE CROSS BLUE SHIELD
TX00875NMedicare PIN