DOUGLAS PARK I LTD NPI 1053395103

NPI Information

  • NPI: 1053395103
  • Provider Name: DOUGLAS PARK I LTD
  • Classification: Clinic/Center - 261QE0700X
  • Specialization: End-Stage Renal Disease (ESRD) Treatment
  • Entity Type: Organization
  • Other Name: MIDLAND DIALYSIS CENTER
  • CLIA Number: 45D0660790
  • Address: 705 W WADLEY AVE
    MIDLAND, TX
    ZIP 79705
  • Phone: (432) 687-1201

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NPI Details

DOUGLAS PARK I LTD is an end-stage renal disease (esrd) treatment clinic center in Midland, TX. DOUGLAS PARK I LTD NPI is 1053395103. The provider is registered as an organization entity type.
The provider Other Name Is Midland Dialysis Center.

The provider's business location address is:

705 W WADLEY AVE
MIDLAND, TX
ZIP 79705-351
Phone: (432) 687-1201
Fax: (432) 687-5008

The provider's authorized official is Douglas Park .
The authorized official title is Medical Director and has the following contact phone number (432) 687-4044.

The CLIA number assigned to this NPI record is 45D0660790 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/2/2005 and was last updated on 2/14/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment006898TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1HH6176OTHERTEXASBC/BS
2452622MEDICARE OSCAR/CERTIFICATIONTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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