LAKE JACKSON DIALYSIS AND KIDNEY CENTER, LTD, LLP (NPI# 1487793386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487793386 |
| Entity Type | Organization |
| Organization Name | LAKE JACKSON DIALYSIS AND KIDNEY CENTER, LTD, LLP |
| Other Organization Name | ANGLETON KIDNEY CENTER |
| Practice Address |
102 E Hospital Dr Angleton TX 77515-4112 |
| Mailing Address |
Po Box 4639 Houston TX 77210-4639 |
| Practice Telephone | 9798644330 |
| Practice Fax Number | 9798643560 |
| Mailing Telephone | 9798644330 |
| Mailing Fax Number | 9798643560 |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2009-08-10 |
| Authorized Official Name | JUDITH GOLD (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9798644330 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
008264 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 182096102 | 05 |
| Other Name | Type Code |
|---|---|
| Angleton Kidney Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215961545 | Lake Jackson Dialysis and Kidney Center, Ltd, LLP | Clinic/Center | 450 This Way St Ste A, Lake Jackson, TX 77566-5152 | 2006-07-11 |
| Street Address |
102 E HOSPITAL DR |
| City | ANGLETON |
| State | TX |
| Zip Code | 77515-4112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043627003 | Renal Treatment Centers-southeast, Lp | Clinic/Center | 102 E Hospital Dr, Angleton, TX 77515-4146 | 2014-07-22 |
| 1306017975 | Charlene Cortez | Dietitian, Registered | 102 E Hospital Dr, Angleton, TX 77515-4112 | 2008-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932725561 | Eve Salinas | Registered Nurse | 610 Cr 199 #11, Angelon, TX 77515 | 2020-06-19 |
| 1861953754 | Ez Pharmacy Group LLC | Pharmacy | 1100 C E Mulberry, Angelton, TX 77515 | 2019-03-25 |
| 1063910230 | Servicios Medicos Para Todos S.a. De C.v. | General Acute Care Hospital | 872-874 Av. Lopez Portillo Sm 59 Mz 37, Unidad Morelos Entre Av. Kabah Y Av. Comalcalco, Cancun, QUINTANA ROO 77515 | 2018-01-23 |
| 1922536671 | Covenant Mobile Healthcare LLC | Nurse Practitioner | Family First Primary Care, 732 E. Henderson Rd, Angleton, TX 77515 | 2017-05-25 |
| 1992254726 | Stephen Ricks Jr. | Nurse Practitioner | 732 E. Henderson Rd, Angleton, TX 77515 | 2016-09-21 |
| 1568849867 | Nancy Vanaphan | Physician Assistant | 146 E Hospital Dr Ste 208, Angleton, TX 77515 | 2015-05-06 |
| 1235560723 | Neuro Analysis Diagnostics | Clinic/Center | 2315 E. Magnolia St., Angleton, TX 77515 | 2013-12-09 |
| 1619308327 | Patricia G. Rios | Speech-Language Pathologist | 120 E. Hospital Dr., Angleton, TX 77515 | 2013-12-05 |
| 1336587716 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 800 N. Arcola, Angelton, TX 77515 | 2013-06-07 |
| 1356620314 | Monica Rose Mehalshick | Contractor | 1820 County Road 36, Serenity Light Recovery LLC, Angleton, TX 77515 | 2011-08-09 |
| Find all providers in zip 77515 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043627003 | Renal Treatment Centers-southeast, Lp | Clinic/Center | 102 E Hospital Dr, Angleton, TX 77515-4146 | 2014-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942801931 | Usrc Mckinney, LLC | Clinic/Center | 1434 N Central Expy Ste 116, Mckinney, TX 75070-3108 | 2020-11-05 |
| 1437756772 | Usrc Bluebonnet, LLC | Clinic/Center | 1902 Windsor Pl, Ste 100, Fort Worth, TX 76110-1866 | 2020-10-08 |
| 1609473941 | Usrc Bluebonnet Home, LLC | Clinic/Center | 1902 Windsor Pl Ste 202, Fort Worth, TX 76110-1866 | 2020-10-08 |
| 1982210050 | Usrc Stephenville LLC | Clinic/Center | 942 Bluebonnet Dr, Stephenville, TX 76401-1764 | 2020-09-23 |
| 1801402979 | Usrc Garland LLC | Clinic/Center | 219 W Kingsley Rd Ste 316, Garland, TX 75041-3434 | 2020-09-23 |
| 1003422171 | Usrc Dialysis At Home West LLC | Clinic/Center | 12011 State Highway 151 Ste 222, San Antonio, TX 78251-1230 | 2020-09-23 |
| 1477165462 | Fresenius Medical Care South Lewisville, LLC | Clinic/Center | 101 E Southwest Pkwy Ste 110, Lewisville, TX 75067-8753 | 2020-08-20 |
| 1598383259 | Dialysis Clinic Inc. | Clinic/Center | 6146 Wurzbach Road, San Antonio, TX 78238 | 2020-07-09 |
| 1891312559 | Usrc Houston Newco Home LLC | Clinic/Center | 2000 Crawford St Ste 777, Houston, TX 77002-9006 | 2020-06-29 |
| 1427671502 | Usrc Plano Dexter, LLC | Clinic/Center | 4708 Dexter Dr, Plano, TX 75093-5288 | 2020-05-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on LAKE JACKSON DIALYSIS AND KIDNEY CENTER, LTD, LLP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.