Active NPI
Clough Dialysis LLC
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Frisco, TX
National Provider Identifier
1104378397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Legal business name
- CLOUGH DIALYSIS LLC
- Practice address
- 6116 Sports Village Rd
Frisco, TX 75033-3584 - Phone
- (469) 362-5763
- NPI assigned
- Nov 4, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Gary J Booth
- Title
- Ceo
- Phone
- (305) 651-3261
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | Primary |
Addresses
Primary practice location
6116 Sports Village Rd
Frisco, TX 75033-3584
Mailing address
19559 NE 10TH Ave
North Miami Beach, FL 33179-3501
Phone (305) 651-3261
Other names 1
- Physicians Dialysis Frisco
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Donna, TX
- NPI 1902353543
Member Of
Locations
19559 NE 10th Ave
North Miami Beach, FL 33179
Phone (305) 651-3261
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1478217600000",
"number": "1104378397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19559 NE 10TH AVE",
"city": "NORTH MIAMI BEACH",
"state": "FL",
"postal_code": "331793501",
"telephone_number": "305-651-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6116 SPORTS VILLAGE RD",
"city": "FRISCO",
"state": "TX",
"postal_code": "750333584",
"telephone_number": "469-362-5763"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLOUGH DIALYSIS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-04",
"last_updated": "2016-11-04",
"status": "A",
"authorized_official_last_name": "BOOTH",
"authorized_official_first_name": "GARY",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "305-651-3261",
"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": [
{
"organization_name": "Physicians Dialysis Frisco",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Frisco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.