Healthcare Provider Details

I. General information

NPI: 1376010785
Provider Name (Legal Business Name): BIO-MEDICAL APPLICATIONS OF TEXAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2018
Last Update Date: 10/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 EMMETT F LOWRY EXPY STE 201
TEXAS CITY TX
77591-9119
US

IV. Provider business mailing address

8900 EMMETT F LOWRY EXPY STE 201
TEXAS CITY TX
77591-9119
US

V. Phone/Fax

Practice location:
  • Phone: 409-933-0406
  • Fax:
Mailing address:
  • Phone: 409-933-0406
  • Fax:

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: MARK FAWCETT
Title or Position: SENIOR VICE PRESIDENT & TREASURER
Credential:
Phone: 781-699-9000