MEDICARE: RENAL SOLUTIONS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	007993	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467513051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	2756 W T C JESTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-7003
Country	:	US
Telephone Number	:	713-680-9056
Fax Number	:	713-680-9310

Provider Business Practice Location Address
First Line	:	2756 W T C JESTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-7003
Country	:	US
Telephone Number	:	713-680-9056
Fax Number	:	713-680-9310

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. MARIE DEGUZMAN
Credential	:	R.N.
Telephone Number	:	713-680-9056

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	03/24/2008

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Directions to “RENAL SOLUTIONS, INC. ” Practice Location

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