Provider Demographics
NPI:1912079658
Name:KIDNEY SOLUTIONS OF TEXAS LLC
Entity Type:Organization
Organization Name:KIDNEY SOLUTIONS OF TEXAS LLC
Other - Org Name:HOUSTON HOME DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EASON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-661-7733
Mailing Address - Street 1:2626 SOUTH LOOP W
Mailing Address - Street 2:#520
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2691
Mailing Address - Country:US
Mailing Address - Phone:713-661-7733
Mailing Address - Fax:713-661-7755
Practice Address - Street 1:2626 SOUTH LOOP W
Practice Address - Street 2:#520
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2691
Practice Address - Country:US
Practice Address - Phone:713-661-7733
Practice Address - Fax:713-661-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008321261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX672562Medicare Oscar/Certification
TX672562Medicare PIN