Healthcare Provider Details
I. General information
NPI: 1538636949
Provider Name (Legal Business Name): FRESENIUS MEDICAL CARE GREATER SOUTHEAST HOUSTON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2018
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3567 PALMER HWY STE C
TEXAS CITY TX
77590-6572
US
IV. Provider business mailing address
3567 PALMER HWY STE C
TEXAS CITY TX
77590-6572
US
V. Phone/Fax
- Phone: 409-948-9300
- Fax: 409-948-9403
- Phone: 409-948-9300
- Fax: 409-948-9403
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 | |
| License Number State | |
VIII. Authorized Official
Name:
BARRY
L.
BLANTON
Title or Position: VICE PRESIDENT
Credential:
Phone: 781-699-9000