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NPI Code Detail

MEDICARE: STAT DIALYSIS CORPORATION

MEDICARE: STAT DIALYSIS CORPORATION
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1821100793
Entity Type Code : Organization
Provider Name (Legal Business Name) : STAT DIALYSIS CORPORATION
Provider Business Mailing Address
First Line : 1914 CAROLINE ST
Second Line : SUITE 140
City : HOUSTON
State : TX
Zip : 77002-8210
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1914 CAROLINE ST
Second Line : SUITE 140
City : HOUSTON
State : TX
Zip : 77002-8210
Country : US
Telephone Number : 713-951-9328
Fax Number :
Authorized Official
Title or Position : TREASURER
Name : MARK FAWCETT
Credential :
Telephone Number : 781-402-9000
Provider Enumeration Date : 08/31/2006
Last Update Date : 08/22/2020

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Directions to “STAT DIALYSIS CORPORATION ” Practice Location

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