Provider Demographics
NPI:1952615361
Name:KIDNEY SPECIALISTS OF NORTH HOUSTON
Entity Type:Organization
Organization Name:KIDNEY SPECIALISTS OF NORTH HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALNG COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-926-0849
Mailing Address - Street 1:37 PEBBLE HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4804
Mailing Address - Country:US
Mailing Address - Phone:713-726-6755
Mailing Address - Fax:
Practice Address - Street 1:129 VISION PARK BLVD STE 109
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3024
Practice Address - Country:US
Practice Address - Phone:936-273-0836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty