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General NPI Number Information
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NPI Number | 1689547036
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Entity Type | Organization
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Legal Business Name | THE KIDNEY CLINIC PLLC
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 12/21/2025
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Provider Practice Location Address
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Address Line | 3115 COLLEGE PARK DR STE 103C
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City | CONROE
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State | TX
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Zip | 77384-4001
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Country | US
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Telephone | 734-985-8467
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Fax |
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Provider Business Mailing Address
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Address Line | 3115 COLLEGE PARK DR STE 103C
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City | THE WOODLANDS
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State | TX
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Zip | 77384-4001
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Country | US
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Telephone | 734-985-8467
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARINI PAL BEJJANKI
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Credential | MD
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Telephone | 936-271-3400
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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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