MEDICARE: RENAL SOLUTIONS DIALYSIS SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2472R0900X	Renal Dialysis Technician	007993	TX

General Provider Information

NPI Number	:	1184718173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENAL SOLUTIONS DIALYSIS SERVICES

Provider Business Mailing Address
First Line	:	2756 WEST T C JESTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018
Country	:	US
Telephone Number	:	713-680-9056
Fax Number	:	713-680-9310

Provider Business Practice Location Address
First Line	:	2756 WEST T C JESTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018
Country	:	US
Telephone Number	:	713-680-9056
Fax Number	:	713-680-9310

Authorized Official
Title or Position	:	MEDICAL DIRECTOR OWNER
Name	:	MS. MARIE DE GUZMEN
Credential	:	RM
Telephone Number	:	713-680-9056

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/22/2020

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