Provider Demographics
NPI:1457360992
Name:GARG, RENU (MD)
Entity type:Individual
Prefix:DR
First Name:RENU
Middle Name:
Last Name:GARG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2636 ALBANS RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1308
Mailing Address - Country:US
Mailing Address - Phone:713-666-7521
Mailing Address - Fax:713-880-4706
Practice Address - Street 1:1919 NORTH LOOP W STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1368
Practice Address - Country:US
Practice Address - Phone:713-868-0029
Practice Address - Fax:713-880-4706
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG 50782080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0095HLOtherBCBS
TX039450402Medicaid
TX039450403OtherMEDICAID EPS
TX8377B6Medicare PIN
TXE36547Medicare UPIN