TEXARKANA KIDNEY DISEASE & HYPERTENSION CENTER INC. NPI 1316009913

NPI Information

TEXARKANA KIDNEY DISEASE & HYPERTENSION CENTER, INC. is a specialist in Lewisville, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. TEXARKANA KIDNEY DISEASE & HYPERTENSION CENTER, INC. NPI is 1316009913. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Lewisville Dialysis.

The provider's business location address is:

120 11TH STREET
LEWISVILLE, AR
ZIP 71845
Phone: (870) 921-4111
Fax: (870) 772-7692

The provider's authorized official is D. Michael Blankenship .
The authorized official title is President and has the following contact phone number (870) 773-1111.

The CLIA number assigned to this NPI record is 04D2233719 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 6/20/2008.

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:

Other Identifiers

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

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