Organization Active NPI

Renal Specialists of Houston, PA

  • Specialist
  • Houston, TX
National Provider Identifier
1275649402
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
RENAL SPECIALISTS OF HOUSTON, PA
Practice address
11665 Fuqua St Ste C301
Houston, TX 77034-4632
Phone
(713) 947-9509
NPI assigned
Aug 21, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
RENAL SPECIALISTS OF HOUSTONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Julia A Tice
Title
Business Manager
Phone
(713) 947-9509

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

11665 Fuqua St Ste C301
Houston, TX 77034-4632

Mailing address

11665 Fuqua St Ste C301
Houston, TX 77034-4632
Phone (713) 947-9509

Other identifiers 1

IdentifierTypeStateIssuer
09366841MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000319 TX Part B Supplier - Clinic/Group Practice 5193613149 Receives reassigned benefits from 26 practitioners
Practice locations: Houston, TX; Webster, TX; The Woodlands, TX; Sugar Land, TX; Pearland, TX; Pasadena, TX; Katy, TX; Humble, TX…

National Provider Directory

National Provider Directory
Part of
Renal Spec of Houston PA

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2625 S Highway 35 Byp
Alvin, TX 77511
Phone (713) 944-4660

2215 Rollingbrook Dr
Ste 140
Baytown, TX 77521
Phone (281) 428-2487

4201 Garth Rd
Ste 319
Baytown, TX 77521
Phone (281) 422-3682

11665 Fuqua St
Ste C301
Houston, TX 77034
Phone (713) 947-1001

11914 Astoria Blvd
Ste 420
Houston, TX 77089
Phone (281) 484-9070

11914 Astoria Blvd
Ste 530
Houston, TX 77089
Phone (281) 301-8626

4407 Yoakum Blvd
Ste B
Houston, TX 77006
Phone (281) 528-8111

4810 E Sam Houston Pkwy N
Houston, TX 77015
Phone (281) 862-9106

8866 Gulf Fwy
Ste 425
Houston, TX 77017
Phone (713) 947-9509

18648 McKay Dr
Ste 130
Humble, TX 77338
Phone (832) 381-2441

21755 Provincial Blvd
Katy, TX 77450
Phone (281) 492-3401

3333 Bayshore Blvd
Ste 270
Pasadena, TX 77504
Phone (713) 947-9507

3337 Plainview St
#B6
Pasadena, TX 77504
Phone (713) 947-9507

2743 Smith Ranch Rd
Ste 803
Pearland, TX 77584
Phone (713) 944-4660

9449 Grogans Mill Rd
The Woodlands, TX 77380
Phone (281) 363-1262

100 E Nasa Pkwy
Ste 35
Webster, TX 77598
Phone (281) 332-2059

450 W Medical Center Blvd
Ste 610
Webster, TX 77598
Phone (281) 332-2059

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1275649402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11665 FUQUA ST STE C301",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770344632",
            "telephone_number": "713-947-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11665 FUQUA ST STE C301",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770344632",
            "telephone_number": "713-947-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL SPECIALISTS OF HOUSTON, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RENAL SPECIALISTS OF HOUSTON",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TICE",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "713-947-9509"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09366841",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.