MEDICARE: H MICHAEL OGBURN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	F3572	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P01090518	OTHER	TX	RAILROAD MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00HK40	OTHER		BCBS#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	82C329	OTHER	TX	BCBS
4	8DE542	OTHER	TX	BC/BS #
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	390001408	OTHER		RARILROAD GBA#
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	390002501	OTHER		RAILROAD GBA #

General Provider Information

NPI Number	:	1295767515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	H MICHAEL OGBURN MD

Provider Business Mailing Address
First Line	:	450 THIS WAY ST STE B
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5152
Country	:	US
Telephone Number	:	979-297-2220
Fax Number	:	979-297-3330

Provider Business Practice Location Address
First Line	:	7777 SOUTHWEST FREEWAY
Second Line	:	SUITE 1052
City	:	HOUSTON
State	:	TX
Zip	:	77074
Country	:	US
Telephone Number	:	713-988-8776
Fax Number	:	713-988-8662

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	01/23/2025

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