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General NPI Number Information
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NPI Number | 1578106894
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Entity Type | Organization
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Legal Business Name | CARDIORENAL THERAPEUTICS OF NORTH TEXAS PLLC
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Dates
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Enumeration Date | 10/18/2019
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Last Update Date | 10/18/2019
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Provider Practice Location Address
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Address Line | 300 N HIGHLAND AVE STE 365
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City | SHERMAN
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State | TX
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Zip | 75092-7393
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Country | US
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Telephone | 516-721-7069
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Fax |
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Provider Business Mailing Address
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Address Line | 2215 LORING DR
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City | ALLEN
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State | TX
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Zip | 75013-5840
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Country | US
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Telephone | 516-721-7069
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REHAN SHAH
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Credential | M.D.
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Telephone | 516-721-7069
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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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