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General NPI Number Information
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NPI Number | 1487902946
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Entity Type | Organization
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Legal Business Name | LAREDO RENAL CARE, PLLC
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Dates
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Enumeration Date | 08/15/2012
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Last Update Date | 10/16/2012
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Provider Practice Location Address
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Address Line | 1710 E SAUNDERS ST STE B675
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City | LAREDO
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State | TX
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Zip | 78041-5456
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Country | US
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Telephone | 210-616-9990
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Fax | 210-616-9988
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Provider Business Mailing Address
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Address Line | PO BOX 591699
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City | SAN ANTONIO
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State | TX
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Zip | 78259-0134
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Country | US
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Telephone | 210-616-9990
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Fax | 210-616-9988
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | ANWAR S GERGES
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Credential | MD
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Telephone | 956-726-8240
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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