Provider Demographics
NPI:1609054683
Name:SUGARLAND DIALYSIS SOUTH, LLC
Entity Type:Organization
Organization Name:SUGARLAND DIALYSIS SOUTH, LLC
Other - Org Name:SUGAR LAND DIALYSIS SOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KALEN
Authorized Official - Middle Name:LUCILLE
Authorized Official - Last Name:BROWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-864-4330
Mailing Address - Street 1:13515 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3562
Mailing Address - Country:US
Mailing Address - Phone:281-240-1364
Mailing Address - Fax:281-240-1427
Practice Address - Street 1:13515 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3562
Practice Address - Country:US
Practice Address - Phone:281-240-1364
Practice Address - Fax:281-240-1427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment