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General NPI Number Information
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NPI Number | 1912177072
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Entity Type | Organization
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Legal Business Name | GREENVILLE DIALYSIS PARTNERS, LP
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 03/05/2008
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Provider Practice Location Address
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Address Line | 4309 RIDGECREST ROAD SUITE 100
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City | GREENVILLE
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State | TX
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Zip | 75402-6004
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Country | US
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Telephone | 903-408-1900
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Fax | 903-408-5121
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Provider Business Mailing Address
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Address Line | 4211 JOE RAMSEY BLVD E SUITE 203
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City | GREENVILLE
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State | TX
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Zip | 75401-7852
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Country | US
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Telephone | 903-408-1900
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Fax | 903-408-5121
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Authorized Official
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Title or Position | DIRECTOR
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Name | KHALID MAHMOOD
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Credential | MD
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Telephone | 903-408-1900
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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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