Healthcare Provider Details

I. General information

NPI: 1396848313
Provider Name (Legal Business Name): GREATER HOUSTON KIDNEY SPECIALISTS LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10023 SOUTH MAIN SUITE C-9 MAIN MEDICAL PLAZA
HOUSTON TX
77025
US

IV. Provider business mailing address

7447 CAMBRIDGE ST #111
HOUSTON TX
77054
US

V. Phone/Fax

Practice location:
  • Phone: 713-496-1077
  • Fax: 713-791-1710
Mailing address:
  • Phone: 713-790-6209
  • Fax: 713-793-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZN0300X
TaxonomyNephrology Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MARIO ASSOUAD
Title or Position: PRESIDENT
Credential: MD
Phone: 713-790-6209