Organization
WHARTON KIDNEY CENTER,LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
H. MICHAEL OGBURN MD (MEDICAL DIRECTOR)
(979) 282-8484
Entity
Organization
Contact information
Practice address
103 WEST AHLDAG STREET, WHARTON, TX 77488-2407
(979) 282-8484
(979) 282-8489
Mailing address
PO BOX 4639, HOUSTON, TX 77210-4639
(979) 864-4330
(979) 864-3560
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
008436
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186312802
—
TX
Enumeration date
02/05/2007
Last updated
08/10/2009
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