Provider Demographics
NPI:1861877607
Name:MCALLEN CHILDRENS DIALYSIS CENTER
Entity type:Organization
Organization Name:MCALLEN CHILDRENS DIALYSIS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SUCHETHA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:BADDAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-521-6224
Mailing Address - Street 1:2001 S CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1298
Mailing Address - Country:US
Mailing Address - Phone:956-664-8381
Mailing Address - Fax:956-664-8395
Practice Address - Street 1:2001 S CYNTHIA ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1298
Practice Address - Country:US
Practice Address - Phone:956-664-8381
Practice Address - Fax:956-664-8395
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KRISHNA TURLAPATI MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-22
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment