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General NPI Number Information
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NPI Number | 1043697220
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Entity Type | Organization
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Legal Business Name | TERRA-BOSON HOME DIALYSIS, LLC
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 04/27/2015
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Provider Practice Location Address
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Address Line | 7015 ALMEDA RD SUITE 3
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City | HOUSTON
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State | TX
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Zip | 77054-2101
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Country | US
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Telephone | 832-706-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 7015 ALMEDA RD SUITE 3
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City | HOUSTON
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State | TX
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Zip | 77054-2101
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Country | US
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Telephone | 713-520-6875
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. UDAY KHOSLA
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Credential | M.D.
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Telephone | 713-520-6875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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