Provider Demographics
NPI:1396144705
Name:SNG NARANJITO LLC
Entity type:Organization
Organization Name:SNG NARANJITO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BORREGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-594-0550
Mailing Address - Street 1:ROAD 164 KM 69
Mailing Address - Street 2:
Mailing Address - City:NARANJITO
Mailing Address - State:PR
Mailing Address - Zip Code:00719
Mailing Address - Country:US
Mailing Address - Phone:972-594-0550
Mailing Address - Fax:972-594-1714
Practice Address - Street 1:4425 W AIRPORT FWY STE 450
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-5848
Practice Address - Country:US
Practice Address - Phone:972-594-0550
Practice Address - Fax:972-594-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR402546Medicare Oscar/Certification