Nacogdoches Dialysis Center LP

Primary specialty

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

Legal business name

NACOGDOCHES DIALYSIS CENTER LP

Practice address

3226 N University Dr Ste 100
Nacogdoches, TX 75965-2684

Phone

(936) 559-0031

Fax

(936) 559-0037

NPI assigned

Sep 15, 2009

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kinam C. Martin

Title

Chief Operations Officer

Phone

(817) 725-7900

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114250750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043029",
            "telephone_number": "817-725-7900",
            "fax_number": "682-207-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3226 N UNIVERSITY DR STE 100",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652684",
            "telephone_number": "936-559-0031",
            "fax_number": "936-559-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES DIALYSIS CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KINAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "817-725-7900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366218101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "110360",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nacogdoches County Hospital District (Nacogdoches Memorial Hospital Day Surg CIDC)
• Nacogdoches Csnhc Enterprises, LLC (Willowbrook Nursing Center)
• Nacogdoches Dental Group PLLC
• Nacogdoches Dental PLLC
• Nacogdoches Dialysis Center LP
• Nacogdoches Emergency Medicine Associates PA
• Nacogdoches Emergency Medicine Associates, PA
• Nacogdoches Eye Associates, PLLC
• Nacogdoches Family Practice, PA
• Nacogdoches Gastroenterology PLLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Nacogdoches, TX
• Providers in Nacogdoches, 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 Jul 21, 2022; 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.