MEDICARE: DR. RENU GARG 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	2080A0000X	Pediatric Adolescent Medicine Physician	G 5078	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0095HL	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457360992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENU GARG MD

Provider Business Mailing Address
First Line	:	2636 ALBANS RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-1308
Country	:	US
Telephone Number	:	713-666-7521
Fax Number	:	713-880-4706

Provider Business Practice Location Address
First Line	:	1919 NORTH LOOP W STE 200
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-1368
Country	:	US
Telephone Number	:	713-868-0029
Fax Number	:	713-880-4706

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	08/12/2014

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Directions to “ DR. RENU GARG MD” Practice Location

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