MEDICARE: DIALYSIS SOLUTIONS, INC.

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	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	PENDING	TX

General Provider Information

NPI Number	:	1265655740
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIALYSIS SOLUTIONS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 2242
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77252-2242
Country	:	US
Telephone Number	:	713-655-0400
Fax Number	:	713-655-0401

Provider Business Practice Location Address
First Line	:	2424 HAMILTON ST STE 210
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-1203
Country	:	US
Telephone Number	:	713-655-0400
Fax Number	:	713-655-0401

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. COLVILLE WILLIAMS
Credential	:	MD
Telephone Number	:	713-655-0400

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	04/25/2008

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