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General NPI Number Information
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NPI Number | 1366616062
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Entity Type | Organization
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Legal Business Name | USRC HERMANN PARK DIALYSIS LLC
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 2001 HERMANN DR
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City | HOUSTON
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State | TX
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Zip | 77004-7643
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Country | US
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Telephone | 214-736-2732
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Fax | 972-367-6011
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Provider Business Mailing Address
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Address Line | 14651 DALLAS PKWY SUITE 900
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City | DALLAS
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State | TX
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Zip | 75254-7476
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Country | US
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Telephone | 214-736-2732
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Fax | 972-367-6011
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | THOMAS L. WEINBERG
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Credential |
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Telephone | 214-736-2732
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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 |
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License Number State |
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