Provider Demographics
NPI:1023146560
Name:KIDNEY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:KIDNEY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF M.D.
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ZALE
Authorized Official - Last Name:FADEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-795-5511
Mailing Address - Street 1:PO BOX 300970
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-0970
Mailing Address - Country:US
Mailing Address - Phone:713-795-5511
Mailing Address - Fax:713-795-4627
Practice Address - Street 1:6560 FANNIN ST STE 1730
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2735
Practice Address - Country:US
Practice Address - Phone:713-795-5511
Practice Address - Fax:713-795-4627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2022-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092271803Medicaid
TXB22602Medicare UPIN
TXF68756Medicare UPIN
TXH16750Medicare UPIN
TXQ11829Medicare UPIN
TXC21146Medicare UPIN
TXI35316Medicare UPIN