Provider Demographics
NPI:1205014495
Name:KIDNEY TREATMENT CENTERS
Entity Type:Organization
Organization Name:KIDNEY TREATMENT CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUPERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-774-9090
Mailing Address - Street 1:PO BOX 2169
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-2169
Mailing Address - Country:US
Mailing Address - Phone:713-774-9090
Mailing Address - Fax:713-774-9091
Practice Address - Street 1:6633 HILLCROFT ST
Practice Address - Street 2:#118
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4887
Practice Address - Country:US
Practice Address - Phone:713-774-9090
Practice Address - Fax:713-774-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-10
Last Update Date:2008-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5868207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17361902Medicaid
TX612111Medicare PIN
TX17361902Medicaid
TX611712Medicare PIN