Healthcare Provider Details

I. General information

NPI: 1740757962
Provider Name (Legal Business Name): FRESENIUS MEDICAL CARE GREATER SOUTHEAST HOUSTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2018
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 CRENSHAW RD STE 200
PASADENA TX
77505-3047
US

IV. Provider business mailing address

5040 CRENSHAW RD STE 200
PASADENA TX
77505-3047
US

V. Phone/Fax

Practice location:
  • Phone: 832-703-0450
  • Fax: 832-703-0456
Mailing address:
  • Phone: 832-703-0450
  • Fax: 832-703-0456

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: BARRY BLANTON
Title or Position: VP
Credential:
Phone: 781-699-9000