Provider Demographics
NPI:1265720940
Name:GREATER HOUSTON CHRONIC DIALYSIS LLC
Entity type:Organization
Organization Name:GREATER HOUSTON CHRONIC DIALYSIS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEREM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-748-0554
Mailing Address - Street 1:5910 SCOTT ST STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1459
Mailing Address - Country:US
Mailing Address - Phone:713-520-6875
Mailing Address - Fax:713-520-6876
Practice Address - Street 1:5910 SCOTT ST STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1459
Practice Address - Country:US
Practice Address - Phone:713-520-6875
Practice Address - Fax:713-520-6876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-15
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment