Provider Demographics
NPI:1538743547
Name:HOUSTON HYPERTENSION & KIDNEY CONSULTANTS, LLC
Entity type:Organization
Organization Name:HOUSTON HYPERTENSION & KIDNEY CONSULTANTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-742-3883
Mailing Address - Street 1:428 STREAMVIEW LN
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6030
Mailing Address - Country:US
Mailing Address - Phone:239-220-6601
Mailing Address - Fax:855-597-8504
Practice Address - Street 1:606 TAYLOR ELAINE DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6794
Practice Address - Country:US
Practice Address - Phone:239-220-6601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSTON RENAL CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-06
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty