Basic Information
| Provider Information | |||||||||
| NPI: | 1457754970 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH TEXAS HOME DIALYSIS THERAPIES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9900 N CENTRAL EXPY | ||||||||
| Address2: | SUITE 215 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752314395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143964950 | ||||||||
| FaxNumber: | 8774235360 | ||||||||
| Practice Location | |||||||||
| Address1: | 2727 BOLTON BOONE DR STE 103 | ||||||||
| Address2: | |||||||||
| City: | DESOTO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 751152019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4698952008 | ||||||||
| FaxNumber: | 4698952208 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2014 | ||||||||
| LastUpdateDate: | 05/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | KUMAR | ||||||||
| AuthorizedOfficialFirstName: | SUMIT | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9726801577 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 05/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0700X | Y | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment |
No ID Information.