| NPI | 1376053892 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BALI REDDY SODAM Owner 580-536-5273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-01-12 |