Provider Demographics
NPI:1730846031
Name:TEXAS CARE DIALYSIS LLC
Entity type:Organization
Organization Name:TEXAS CARE DIALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-628-2646
Mailing Address - Street 1:11161 SHADOW CREEK PKWY STE 107
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7286
Mailing Address - Country:US
Mailing Address - Phone:713-628-2646
Mailing Address - Fax:
Practice Address - Street 1:11161 SHADOW CREEK PKWY STE 107
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7286
Practice Address - Country:US
Practice Address - Phone:281-501-1602
Practice Address - Fax:281-529-6278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-21
Last Update Date:2021-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment