Provider Demographics
NPI:1275901662
Name:A-TEAM DIALYSIS, LLC
Entity Type:Organization
Organization Name:A-TEAM DIALYSIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:C
Authorized Official - Last Name:SILORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-807-4086
Mailing Address - Street 1:9803 WINTER RUN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-5293
Mailing Address - Country:US
Mailing Address - Phone:281-935-5093
Mailing Address - Fax:
Practice Address - Street 1:11929 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2451
Practice Address - Country:US
Practice Address - Phone:281-935-5093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD1100XNursing Service ProvidersRegistered NurseDialysis, PeritonealGroup - Single Specialty