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General NPI Number Information
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NPI Number | 1275901662
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Entity Type | Organization
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Legal Business Name | A-TEAM DIALYSIS, LLC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 11929 W AIRPORT BLVD
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City | STAFFORD
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State | TX
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Zip | 77477-2451
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Country | US
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Telephone | 281-935-5093
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Fax |
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Provider Business Mailing Address
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Address Line | 9803 WINTER RUN DR
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City | HOUSTON
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State | TX
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Zip | 77064-5293
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Country | US
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Telephone | 281-935-5093
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. RICKY C SILORAN
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Credential |
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Telephone | 281-807-4086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WD1100X
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Taxonomy Name | Peritoneal Dialysis Registered Nurse
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License Number |
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License Number State |
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