Provider Demographics
NPI:1124140462
Name:UREA DIALYSIS INC
Entity type:Organization
Organization Name:UREA DIALYSIS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-313-0449
Mailing Address - Street 1:13000 MURPHY RD
Mailing Address - Street 2:STE 120
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3970
Mailing Address - Country:US
Mailing Address - Phone:281-313-0449
Mailing Address - Fax:713-981-7774
Practice Address - Street 1:13000 MURPHY RD
Practice Address - Street 2:STE 120
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3970
Practice Address - Country:US
Practice Address - Phone:281-313-0449
Practice Address - Fax:713-981-7774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5209261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN
TX=========OtherEIN