Healthcare Provider Details

I. General information

NPI: 1164624888
Provider Name (Legal Business Name): BIO-MEDICAL APPLICATIONS OF TEXAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 S STATE HIGHWAY 6 CKD SERVICES OF MARLIN
MARLIN TX
76661-3527
US

IV. Provider business mailing address

920 WINTER ST CKD SERVICES
WALTHAM MA
02451-1457
US

V. Phone/Fax

Practice location:
  • Phone: 254-883-3699
  • Fax: 254-883-3055
Mailing address:
  • Phone: 800-662-1237
  • Fax: 781-699-4046

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: MR. MARK FAWCETT
Title or Position: TREASURER
Credential:
Phone: 781-699-2668