Memorial Peritoneal Dialysis LLC

Primary specialty

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

Legal business name

MEMORIAL PERITONEAL DIALYSIS LLC

Practice address

1170 Blalock Rd
Houston, TX 77055-7421

Phone

(909) 450-7159

NPI assigned

May 24, 2012

Organization subpart

No

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

Authorized official

Name

Elva Agra

Title

Ceo

Phone

(909) 450-7159

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1538429451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 BLALOCK RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770557421",
            "telephone_number": "909-450-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 BLALOCK RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770557421",
            "telephone_number": "909-450-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL PERITONEAL DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "AGRA",
        "authorized_official_first_name": "ELVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-450-7159"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Memorial Pediatric Therapy Associates, PC
• Memorial Pediatrics
• Memorial Pharmacy Group
• Memorial Pharmacy Inc
• Memorial Physicians Association
• Memorial Plastic Surgery Holdings PLLC
• Memorial Plastic Surgery, LLLP

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Houston, TX
• Providers in Houston, 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 May 24, 2012; 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.