Provider Demographics
NPI:1598535650
Name:RENAL CARE HOUSTON PLLC
Entity Type:Organization
Organization Name:RENAL CARE HOUSTON PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHATTAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-752-6199
Mailing Address - Street 1:2299 LONE STAR DR APT 128
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1288
Mailing Address - Country:US
Mailing Address - Phone:312-752-6199
Mailing Address - Fax:
Practice Address - Street 1:205 BELLA KATY DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6821
Practice Address - Country:US
Practice Address - Phone:312-752-6199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty