Provider Demographics
NPI:1023371291
Name:DIALYSPA CONTRACT SERVICES, LLC
Entity Type:Organization
Organization Name:DIALYSPA CONTRACT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:KALINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-218-6500
Mailing Address - Street 1:2453 S. BRAESWOOD BLVD, STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-218-6500
Mailing Address - Fax:
Practice Address - Street 1:2453 S. BRAESWOOD BLVD, STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-218-6500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health