Provider Demographics
NPI:1740757962
Name:FRESENIUS MEDICAL CARE GREATER SOUTHEAST HOUSTON, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE GREATER SOUTHEAST HOUSTON, LLC
Other - Org Name:FRESENIUS KIDNEY CARE PASADENA-CRENSHAW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:5040 CRENSHAW RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3047
Mailing Address - Country:US
Mailing Address - Phone:832-703-0450
Mailing Address - Fax:832-703-0456
Practice Address - Street 1:5040 CRENSHAW RD STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77505-3047
Practice Address - Country:US
Practice Address - Phone:832-703-0450
Practice Address - Fax:832-703-0456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-25
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment