Provider Demographics
NPI:1417474156
Name:ELIK DIALYSIS HOME THERAPY - MEMORIAL II LLC
Entity Type:Organization
Organization Name:ELIK DIALYSIS HOME THERAPY - MEMORIAL II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:IKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-861-7500
Mailing Address - Street 1:1445 NORTH LOOP W STE 740
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1676
Mailing Address - Country:US
Mailing Address - Phone:713-861-7500
Mailing Address - Fax:
Practice Address - Street 1:1445 NORTH LOOP W STE 740
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1676
Practice Address - Country:US
Practice Address - Phone:713-861-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health