Provider Demographics
NPI:1811277486
Name:BEST PEDIATRIC KIDNEY CARE CLINIC INC.
Entity type:Organization
Organization Name:BEST PEDIATRIC KIDNEY CARE CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GULAM
Authorized Official - Middle Name:HUSSAIN
Authorized Official - Last Name:MUSHARAF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-837-9372
Mailing Address - Street 1:12235 STABLE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4653
Mailing Address - Country:US
Mailing Address - Phone:210-837-9372
Mailing Address - Fax:210-579-2062
Practice Address - Street 1:5131 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5062
Practice Address - Country:US
Practice Address - Phone:210-837-9372
Practice Address - Fax:210-579-2062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM95212080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric NephrologyGroup - Single Specialty