Diamond Dialysis - Stafford Texas LLC

Primary specialty

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

Legal business name

DIAMOND DIALYSIS - STAFFORD TEXAS LLC

Practice address

3623 South Main Street
Suite 100
Stafford, TX 77477

Phone

(832) 987-1793

Fax

(832) 987-1873

NPI assigned

Oct 10, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Rodney Wilson

Title

Cfo

Phone

(281) 785-8242

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Diamond Dialysis - Stafford Texas LLCCCN 672886

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Sep 18, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Other

Dialysis stations

13

Locations

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Sachin Soni, M.D

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1205169380

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1507593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507593600000",
    "number": "1104336650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 SOUTH MAIN STREET",
            "address_2": "SUITE #100",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "832-987-1793",
            "fax_number": "832-987-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3623 SOUTH MAIN STREET",
            "address_2": "SUITE 100",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "832-987-1793",
            "fax_number": "832-987-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND DIALYSIS - STAFFORD TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-10",
        "last_updated": "2017-10-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "281-785-8242",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chloe Delepine, PT
• Eileen C Demoor
• Deborah Ann Denissen, LVN
• Devine Solutions Group LLC
• Tabitha Dhodapkar
• Sarah Wilkinson Dietzmann
• Different Direction LLC
• Nathan Michael Diffey
• Brittany Seat Dilleshaw, OTR
• Briana Dimes

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Stafford, TX
• Providers in Stafford, 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 Oct 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.