MATAGORDA DIALYSIS CARE LLP NPI 1104255645

NPI Information

NPI: 1104255645
Provider Name: MATAGORDA DIALYSIS CARE LLP
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 45D0495463

Address:
1105 AVENUE H
BAY CITY, TX
ZIP 77414
Phone: (979) 245-0099
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MATAGORDA DIALYSIS CARE LLP is an end-stage renal disease (esrd) treatment clinic center in Bay City, TX. MATAGORDA DIALYSIS CARE LLP NPI is 1104255645. The provider is registered as an organization entity type.

The provider's business location address is:

1105 AVENUE H
BAY CITY, TX
ZIP 77414-538
Phone: (979) 245-0099
Fax: (979) 245-6435

The provider's authorized official is Shari K Cousins .
The authorized official title is Sr. Vp Of Clinical & Regulatory and has the following contact phone number (978) 922-3080.

The CLIA number assigned to this NPI record is 45D0495463 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/5/2013 and was last updated on 3/17/2020.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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
1	335873101	MEDICAID	TEXAS

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: 11/14/2023

NPI Synchronization or Removal

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