| NPI | 1093903866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEN E. WALLER Admin/Owner 972-816-9299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: TX 011792) |
| Additional Taxonomies | 251E00000X Home Health (Licence: TX 011792) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2020-11-19 |