Organization Name: | NACOGDOCHES DIALYSIS CENTER, L.P. |
NPI Number: | 1114250750 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PONNIAH SANKARAPANDIAN (MEDICAL DIRECTOR) |
Mailing Address: | 1204 N Mound St 100 H Nacogdoches |
State: | TX US |
Postal Code: | 759614027 |
Phone Number: | 9365688510 |
Fax Number: | 9365688517 |
NPI Enumeration Date: | 09/15/2009 |
NPI Last Update Date: | 08/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |