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General NPI Number Information
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NPI Number | 1619014594
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Entity Type | Organization
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Legal Business Name | GLOBAL DIALYSIS PLUS INC.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 12823 CAPRICORN STREET
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City | STAFFORD
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State | TX
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Zip | 77477
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Country | US
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Telephone | 281-980-0446
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Fax | 281-980-0468
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Provider Business Mailing Address
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Address Line | 12823 CAPRICORN STREET
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City | STAFFORD
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State | TX
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Zip | 77477
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Country | US
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Telephone | 281-980-0446
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Fax | 281-980-0468
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. COLETTE MARIE NELSON
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Credential | RN
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Telephone | 713-816-1487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D1083282
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License Number State | TX
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Taxonomy #2
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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 | 008614
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License Number State | TX
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