Organization
SOUTHWEST NEPHROLOGY ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES K CRUMB M.D. (PARTNER)
(713) 270-4545
Entity
Organization
Contact information
Practice address
7777 SOUTHWEST FWY, STE.# 304, HOUSTON, TX 77074-1802
(713) 270-4545
(713) 270-9197
Mailing address
7777 SOUTHWEST FWY, STE.# 304, HOUSTON, TX 77074-1802
(713) 270-4545
(713) 270-9197
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E0322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00BH04
MEDICARE #
TX
05
—
114217602
—
TX
01
—
P00BH046
MEDICAID (TPI & RR)
TX
Enumeration date
09/16/2009
Last updated
09/16/2009
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