Kidneyspa in-Home Dialysis SE Texas LLC

Primary specialty

Home Infusion AgencyTaxonomy code 251F00000X

Legal business name

KIDNEYSPA IN-HOME DIALYSIS SE TEXAS LLC

Practice address

7102 Brookside Rd
Pearland, TX 77581-7323

Phone

(832) 352-4277

NPI assigned

Dec 13, 2021

Organization subpart

No

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

Authorized official

Name

Juan M Cuellar, MD

Title

Member

Phone

(305) 329-2900

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1477212959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 NW 12TH AVE APT 508",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331282206",
            "telephone_number": "305-329-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7102 BROOKSIDE RD",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775817323",
            "telephone_number": "832-352-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEYSPA IN-HOME DIALYSIS SE TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "CUELLAR",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "305-329-2900",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BD1200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rimsha Khan, SLP
• Rizwan Khan, M.D.
• Sajid Raza Khan, M.D.
• Shifa Khan
• Kaitlyn Kibaara, M.S., CCC-SLP
• Christine Kilgallen, LPC
• Andrew J Kim, DO
• Chun M Kim, PHARMD
• Matthew J. Kim, MK
• Steven Kim, PA-C

• Home Infusion Agency in Pearland, TX
• Providers in Pearland, TX by specialty
• Home Infusion Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.