Provider Demographics
NPI:1144539115
Name:NEPHRO HOME DIALYSIS AND TRAINING CENTER, LLC
Entity type:Organization
Organization Name:NEPHRO HOME DIALYSIS AND TRAINING CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMMEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:832-298-3967
Mailing Address - Street 1:15058 HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-3261
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15058 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:ROSHARON
Practice Address - State:TX
Practice Address - Zip Code:77583-3261
Practice Address - Country:US
Practice Address - Phone:832-298-3967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health