Provider Demographics
NPI:1295767515
Name:OGBURN, H MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:H MICHAEL
Middle Name:
Last Name:OGBURN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 THIS WAY ST STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5152
Mailing Address - Country:US
Mailing Address - Phone:979-297-2220
Mailing Address - Fax:979-297-3330
Practice Address - Street 1:7777 SOUTHWEST FREEWAY
Practice Address - Street 2:SUITE 1052
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-988-8776
Practice Address - Fax:713-988-8662
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3572207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00HK40OtherBCBS#
TX123311609Medicaid
TX82C329OtherBCBS
TX8DE542OtherBC/BS #
TXP01090518OtherRAILROAD MEDICARE PTAN
TX123311601Medicaid
390001408OtherRARILROAD GBA#
TX123311604Medicaid
390002501OtherRAILROAD GBA #
C20003Medicare UPIN
TXP01090518OtherRAILROAD MEDICARE PTAN
TX123311601Medicaid
00HK40Medicare PIN