Provider Demographics
NPI:1598160194
Name:NEPHROLOGY ASSOCIATE OF TEXAS CORPORATION
Entity type:Organization
Organization Name:NEPHROLOGY ASSOCIATE OF TEXAS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OLUMAYOWA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADERINTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-239-4249
Mailing Address - Street 1:4502 RIVERSTONE BLVD
Mailing Address - Street 2:UNIT 1403
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5204
Mailing Address - Country:US
Mailing Address - Phone:713-239-4249
Mailing Address - Fax:281-978-4341
Practice Address - Street 1:5307 HEALTH RIVER LANE
Practice Address - Street 2:
Practice Address - City:SUGARLAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:713-239-4249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-27
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty