BRAZORIA KIDNEY CENTER, INC. , NPI 1437261310 — BRAZORIA KIDNEY CENTER in LAKE JACKSON (TX)

NPI 1437261310

13+ Years Experience Organization

BRAZORIA KIDNEY CENTER, INC.

Other organization name: BRAZORIA KIDNEY CENTER. Name type code: 3 - doing business as (d/b/ a) name.

08/31/2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1437261310
NPI NUMBER

About BRAZORIA KIDNEY CENTER, INC.

BRAZORIA KIDNEY CENTER, INC. is a provider established in LAKE JACKSON, TX. The NPI number of BRAZORIA KIDNEY CENTER, INC. is 1437261310 and was assigned on 08/31/2006. The practitioners primary taxonomy code is: 261QE0700X .

Mailing address

  • City: LAKE JACKSON
  • State: TX
  • Postal code: 775665140
  • Address: 405 THIS WAY ST
  • Address 2: SUITE 3

Primary Practice Address

  • Region : LAKE JACKSON, TX
  • NPI : 1437261310
  • Phone : 9792991936
  • Postalcode : 775665140
  • Address : 405 THIS WAY ST SUITE 3

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QE0700X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • BRAZORIA KIDNEY CENTER, INC.
  • Address : 405 THIS WAY ST SUITE 3
  • Region : LAKE JACKSON, TX
  • NPI : 1437261310
  • Phone : 9792991936
  • Postalcode : 775665140

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 7814029000
  • Title or position : TREASURER

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address405 THIS WAY ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 3
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameLAKE JACKSON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code775665140
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number9792991936
The telephone number associated with the location address of the provider being identified.
NPI1437261310
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QE0700X
Provider Enumeration Date08/31/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)BRAZORIA KIDNEY CENTER, INC.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameBRAZORIA KIDNEY CENTER
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address405 THIS WAY ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 3
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameLAKE JACKSON
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code775665140
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Authorized Official Last NameFAWCETT
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameMARK
The first name of the authorized official
Authorized Official Title or PositionTREASURER
The title or position of the authorized official
Authorized Official Telephone Number7814029000
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QE0700X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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