Provider Demographics
NPI:1508040668
Name:ROMANO WOODS KIDNEY CLINIC, INC.
Entity Type:Organization
Organization Name:ROMANO WOODS KIDNEY CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:F
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-790-9080
Mailing Address - Street 1:1415 LA CONCHA LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1801
Mailing Address - Country:US
Mailing Address - Phone:713-790-9080
Mailing Address - Fax:713-335-4281
Practice Address - Street 1:16910 MATHIS CHURCH ROAD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3705
Practice Address - Country:US
Practice Address - Phone:281-433-4792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF67546Medicare UPIN
TXG88585Medicare UPIN
TXE38992Medicare UPIN
TXH36032Medicare UPIN
TXB26770Medicare UPIN
TXG03956Medicare UPIN
TXG28741Medicare UPIN
TXI67287Medicare UPIN
TXI20691Medicare UPIN
TXI05365Medicare UPIN
TXH36191Medicare UPIN