Provider Demographics
NPI:1811195274
Name:GREATER HOUSTON NEPHROLOGY NETWORK
Entity Type:Organization
Organization Name:GREATER HOUSTON NEPHROLOGY NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUGANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-947-9509
Mailing Address - Street 1:8876 GULF FWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-6513
Mailing Address - Country:US
Mailing Address - Phone:713-947-9509
Mailing Address - Fax:713-947-0609
Practice Address - Street 1:8876 GULF FWY
Practice Address - Street 2:SUITE 215
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-6513
Practice Address - Country:US
Practice Address - Phone:713-947-9509
Practice Address - Fax:713-947-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTIN