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General NPI Number Information
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NPI Number | 1467788547
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Entity Type | Organization
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Legal Business Name | ELIK DIALYSIS HOME THERAPY-MEMORIAL INC DBA ELIK DIALYSIS HOME THERAPY
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 1445 NORTH LOOP W STE 720
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City | HOUSTON
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State | TX
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Zip | 77008-1676
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Country | US
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Telephone | 713-861-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 NORTH LOOP W STE 720
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City | HOUSTON
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State | TX
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Zip | 77008-1676
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Country | US
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Telephone | 713-861-7500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MRS. BALBEER K GODWIN
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Credential | REGISTERED NURSE
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Telephone | 281-799-7089
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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 | 012755
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License Number State | TX
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