Mission Dialysis Services LLC

Primary specialty

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

License

110282 Issued in TX

Legal business name

MISSION DIALYSIS SERVICES LLC

Doing business as

Physicians Dialysis Denton

Practice address

3305 Unicorn Lake Blvd
Denton, TX 76210-0102

Phone

(940) 387-4592

NPI assigned

Nov 4, 2016

Organization subpart

Yes

Parent organization

PHYSICIANS DIALYSIS DENTONAs reported in NPPES

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

Authorized official

Name

Miss Gary J Booth

Title

Ceo

Phone

(305) 651-3261

Specialties & licenses 1

Addresses

Other names 1

• Physicians Dialysis Denton Doing business as

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": "1932651155",
    "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": "3305 UNICORN LAKE BLVD",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762100102",
            "telephone_number": "940-387-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION DIALYSIS SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICIANS DIALYSIS DENTON",
        "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": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "110282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians Dialysis Denton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mint Dentistry, PLLC (Denton Mint Dentistry)
• Minyard Food Stores Inc. (Sack 'n Save Pharmacy #202)
• Allison Ann Mirike, P.A.
• Inez Miser
• Anurag Mishra, MD
• Mission Dialysis Services, LLC (Denton Dialysis)
• Angela Rae Mitchell, CCC-SLP
• Camisha Mitchell, CHW/CPW
• Ethan Alan Mitchell, DPT
• Kimberly Sanders Mitchell, PT

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Denton, TX
• Providers in Denton, 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 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.

Verify at the official NPI Registry.