Provider Demographics
NPI:1487902946
Name:LAREDO RENAL CARE, PLLC
Entity type:Organization
Organization Name:LAREDO RENAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANWAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:GERGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-726-8240
Mailing Address - Street 1:PO BOX 591699
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0134
Mailing Address - Country:US
Mailing Address - Phone:210-616-9990
Mailing Address - Fax:210-616-9988
Practice Address - Street 1:1710 E SAUNDERS ST STE B675
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5456
Practice Address - Country:US
Practice Address - Phone:210-616-9990
Practice Address - Fax:210-616-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty