MEDICARE: DR. STEVAN LAWRENCE DINERSTEIN M.D.

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	E0883	TX

General Provider Information

NPI Number	:	1932180791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVAN LAWRENCE DINERSTEIN M.D.

Provider Business Mailing Address
First Line	:	6560 FANNIN ST
Second Line	:	SUITE 2204
City	:	HOUSTON
State	:	TX
Zip	:	77030-2761
Country	:	US
Telephone Number	:	713-793-7550
Fax Number	:	713-793-7555

Provider Business Practice Location Address
First Line	:	6560 FANNIN ST
Second Line	:	SUITE 2204
City	:	HOUSTON
State	:	TX
Zip	:	77030-2761
Country	:	US
Telephone Number	:	713-793-7550
Fax Number	:	713-793-7555

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	04/08/2009

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