Provider Demographics
NPI:1447401765
Name:TEXAS NEPHROLOGY CONSULTANTS, P.A
Entity Type:Organization
Organization Name:TEXAS NEPHROLOGY CONSULTANTS, P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:SHAHROKH
Authorized Official - Last Name:BAHRAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-313-2415
Mailing Address - Street 1:1650 W ROSEDALE ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-7400
Mailing Address - Country:US
Mailing Address - Phone:817-313-2415
Mailing Address - Fax:817-548-9775
Practice Address - Street 1:1650 W ROSEDALE ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-7400
Practice Address - Country:US
Practice Address - Phone:817-313-2415
Practice Address - Fax:817-548-9775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty