Provider Demographics
NPI:1659916617
Name:HEARTLAND PHYSICIANS ASSOCIATES NEPHROLOGY PLLC
Entity Type:Organization
Organization Name:HEARTLAND PHYSICIANS ASSOCIATES NEPHROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ROOHI
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-610-3659
Mailing Address - Street 1:PO BOX 7125
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77387-7125
Mailing Address - Country:US
Mailing Address - Phone:718-841-7318
Mailing Address - Fax:
Practice Address - Street 1:150 PINE FOREST DR STE 501
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-5304
Practice Address - Country:US
Practice Address - Phone:718-841-7318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-14
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty