PROVIDENCE HOME DIALYSIS LLC – NPI #1720782410
Clinic/Center

PROVIDENCE HOME DIALYSIS LLC is an AHC clinic located in HOUSTON, TX. NPPES has assigned the NPI number 1720782410 to PROVIDENCE HOME DIALYSIS LLC on March 28, 2023. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QE0700X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in End-Stage Renal Disease (ESRD) Treatment

The NPI profile was previously updated about 3 years ago on Jul 10, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PROVIDENCE HOME DIALYSIS LLC below.

NPI Profile for
PROVIDENCE HOME DIALYSIS LLC

NPI Number
1720782410
Enumeration Date

(more than 3 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PROVIDENCE HOME DIALYSIS LLC
Primary location
7737 BEECHNUT ST STE 102
HOUSTON, TX 77074-3109
Phone: (713) 861-7500 Fax: (713) 861-7502
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
SHONTA WILLIAMS
COO
Phone: (346) 388-0656
Updated
Certification Date
Jul 10, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0700X
- Clinic/Center / End-Stage Renal Disease (ESRD) Treatment (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.