Douglas Park I LTD

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

006898 Issued in TX

Legal business name

DOUGLAS PARK I LTD

Practice address

705 W Wadley Ave
Midland, TX 79705-5351

Phone

(432) 687-1201

Fax

(432) 687-5008

NPI assigned

Dec 2, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Douglas Park, M.D.

Title

Medical Director

Phone

(432) 687-4044

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Midland Dialysis Center Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202947200000",
    "number": "1053395103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W WADLEY AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797055351",
            "telephone_number": "432-687-1201",
            "fax_number": "432-687-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W WADLEY AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797055351",
            "telephone_number": "432-687-1201",
            "fax_number": "432-687-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS PARK I LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-02",
        "last_updated": "2008-02-14",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "432-687-4044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "006898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "HH6176",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midland Dialysis Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dominique Doria
• Ramon G Doria, REGISTERED NURSE
• Milouse Dornevil
• Erika Lenora Dorsey
• Pamela Floyd Doughty
• Douglas S. Park M.D. PA
• Caroline Elizabeth Downing, MS,RD,LD
• Dr Donald J Ammon Jr DC PLLC
• Dr. James W. Carpenter, O.D.
• Dr. Pepermintwala PLLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Midland, TX
• Providers in Midland, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.