Provider Demographics
NPI:1578106894
Name:CARDIORENAL THERAPEUTICS OF NORTH TEXAS PLLC
Entity Type:Organization
Organization Name:CARDIORENAL THERAPEUTICS OF NORTH TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-721-7069
Mailing Address - Street 1:2215 LORING DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5840
Mailing Address - Country:US
Mailing Address - Phone:516-721-7069
Mailing Address - Fax:
Practice Address - Street 1:300 N HIGHLAND AVE STE 365
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7393
Practice Address - Country:US
Practice Address - Phone:516-721-7069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty