| NPI | 1952400640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEIF GUTTORMSEN Administrator 817-265-7115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment (Licence: TX 000222) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2013-12-03 |