| NPI | 1770990749 |
|---|---|
| Doing Business As | LAKE JACKSON DIALYSIS |
| Entity Type | Organization |
| Authorized Contact | SAMUEL T WEY VP Licensure&Certification 615-341-6641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: TX 110303) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2024-04-22 |