Provider Demographics
NPI:1629197686
Name:HOUSTON HOME DIALYSIS LP
Entity type:Organization
Organization Name:HOUSTON HOME DIALYSIS LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AKIHIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOCHIZUKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-690-2200
Mailing Address - Street 1:11403 REGENCY GREEN DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4706
Mailing Address - Country:US
Mailing Address - Phone:713-690-2200
Mailing Address - Fax:713-690-2204
Practice Address - Street 1:11403 REGENCY GREEN DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4706
Practice Address - Country:US
Practice Address - Phone:713-690-2200
Practice Address - Fax:713-690-2204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010111251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health