=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477185957
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTH BELT KIDNEY CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2020
-----------------------------------------------------
Last Update Date | 11/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3327 S SAM HOUSTON PKWY E STE 200A
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77047-6549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-506-8470
-----------------------------------------------------
Fax | 281-779-8944
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3327 S SAM HOUSTON PKWY E STE 200A
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77047-6549
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-506-8470
-----------------------------------------------------
Fax | 281-506-8751
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR / CFO
-----------------------------------------------------
Name | EDUARDO E GERALDO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-506-8470
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QE0700X
-----------------------------------------------------
Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------