Healthcare Provider Details
I. General information
NPI: 1467513051
Provider Name (Legal Business Name): RENAL SOLUTIONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2756 W T C JESTER BLVD
HOUSTON TX
77018-7003
US
IV. Provider business mailing address
2756 W T C JESTER BLVD
HOUSTON TX
77018-7003
US
V. Phone/Fax
- Phone: 713-680-9056
- Fax: 713-680-9310
- Phone: 713-680-9056
- Fax: 713-680-9310
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | 007993 |
| License Number State | TX |
VIII. Authorized Official
Name: MS.
MARIE
DEGUZMAN
Title or Position: ADMINISTRATOR
Credential: R.N.
Phone: 713-680-9056