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General NPI Number Information
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NPI Number | 1912520412
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Entity Type | Organization
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Legal Business Name | SINGULAR LUXURY DIALYSIS PEARLAND LLC
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 11161 SHADOW CREEK PKWY STE 101
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City | PEARLAND
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State | TX
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Zip | 77584-7286
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Country | US
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Telephone | 346-409-1192
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Fax | 713-413-8886
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Provider Business Mailing Address
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Address Line | 11161 SHADOW CREEK PKWY STE 101
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City | PEARLAND
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State | TX
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Zip | 77584-7286
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Country | US
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Telephone | 832-905-6200
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Fax | 832-850-6482
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JENNIFER ENABE
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Credential | RN
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Telephone | 713-628-2646
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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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