Provider Demographics
NPI:1477185957
Name:SOUTH BELT KIDNEY CENTER LLC
Entity Type:Organization
Organization Name:SOUTH BELT KIDNEY CENTER LLC
Other - Org Name:SOUTH BELT DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CFO
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:E
Authorized Official - Last Name:GERALDO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-506-8470
Mailing Address - Street 1:3327 S SAM HOUSTON PKWY E STE 200A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-6549
Mailing Address - Country:US
Mailing Address - Phone:281-506-8470
Mailing Address - Fax:281-506-8751
Practice Address - Street 1:3327 S SAM HOUSTON PKWY E STE 200A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-6549
Practice Address - Country:US
Practice Address - Phone:281-506-8470
Practice Address - Fax:281-779-8944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-12
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment