Basic Information
Provider Information | |||||||||
NPI: | 1164685731 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | GILBERT | ||||||||
FirstName: | BILLY | ||||||||
MiddleName: | RAY | ||||||||
NamePrefix: | MR. | ||||||||
NameSuffix: | II | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 8876 GULF FREEWAY | ||||||||
Address2: | SUITE 215, RENAL SPECIALISTS OF HOUSTON, PA | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770176550 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7139479509 | ||||||||
FaxNumber: | 7139470609 | ||||||||
Practice Location | |||||||||
Address1: | 6624 FANNIN | ||||||||
Address2: | SUITE 2510, RENAL SPECIALISTS OF HOUSTON, PA | ||||||||
City: | HOUSTON | ||||||||
State: | TX | ||||||||
PostalCode: | 770302337 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7137912648 | ||||||||
FaxNumber: | 7137950717 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/03/2008 | ||||||||
LastUpdateDate: | 02/09/2012 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | BP10023256 | TX | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | N5688 | TX | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.