Provider Demographics
NPI:1497923130
Name:RENU GARG MD PA
Entity Type:Organization
Organization Name:RENU GARG MD PA
Other - Org Name:RENU GARG MD PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-868-0029
Mailing Address - Street 1:1919 NORTH LOOP W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1374
Mailing Address - Country:US
Mailing Address - Phone:713-868-0029
Mailing Address - Fax:713-880-4706
Practice Address - Street 1:1919 NORTH LOOP W
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1374
Practice Address - Country:US
Practice Address - Phone:713-868-0029
Practice Address - Fax:713-880-4706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5078174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0095HLOtherBCBS
TX0095HLOtherBCBS
TXE36547Medicare UPIN