Provider Demographics
NPI:1346740719
Name:DIALYSIS ACCESS CENTER CORPUS CHRISTI ASC LLC
Entity Type:Organization
Organization Name:DIALYSIS ACCESS CENTER CORPUS CHRISTI ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIJIOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-739-0309
Mailing Address - Street 1:PO BOX 412137
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-2137
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5617 TIMBERGATE DR STE 100
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3193
Practice Address - Country:US
Practice Address - Phone:361-880-8322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-13
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical