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General NPI Number Information
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NPI Number | 1053801225
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Entity Type | Organization
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Legal Business Name | DIALYSPA VII LLC
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 1411 BONNER ST.
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City | HOUSTON
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State | TX
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Zip | 77058
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Country | US
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Telephone | 713-814-8741
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 128
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City | BELLAIRE
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State | TX
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Zip | 77402-0128
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Country | US
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Telephone | 281-833-3330
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Fax | 281-833-3323
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Authorized Official
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Title or Position | CEO
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Name | JEFFREY E KALINA
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Credential | MD
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Telephone | 713-218-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 110480
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License Number State | TX
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