Healthcare Provider Details

I. General information

NPI: 1396144705
Provider Name (Legal Business Name): SNG NARANJITO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 08/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 W AIRPORT FWY STE 450
IRVING TX
75062-5848
US

IV. Provider business mailing address

ROAD 164 KM 69
NARANJITO PR
00719
US

V. Phone/Fax

Practice location:
  • Phone: 972-594-0550
  • Fax: 972-594-1714
Mailing address:
  • Phone: 972-594-0550
  • Fax: 972-594-1714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LILLIAN BORREGO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 972-594-0550