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General NPI Number Information
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NPI Number | 1275831604
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Entity Type | Organization
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Legal Business Name | GRAHAM DIALYSIS CENTER, LLC
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 1531 HIGHWAY 380 BYP
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City | GRAHAM
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State | TX
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Zip | 76450-2323
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Country | US
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Telephone | 940-322-1411
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Fax |
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Provider Business Mailing Address
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Address Line | 1531 HIGHWAY 380 BYP
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City | GRAHAM
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State | TX
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Zip | 76450-2323
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ASVIN PATEL
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Credential | MD
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Telephone | 940-322-1411
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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 | K1614
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License Number State | TX
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