Provider Demographics
NPI:1528524295
Name:LUXURY DIALYCARE PLLC
Entity type:Organization
Organization Name:LUXURY DIALYCARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BIOMED TECHNICAL SUPPORT/CONSULTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DONNELL
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:BSTM
Authorized Official - Phone:832-455-9139
Mailing Address - Street 1:600 N. KOBAYASHI ROAD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598
Mailing Address - Country:US
Mailing Address - Phone:281-724-0899
Mailing Address - Fax:832-632-1437
Practice Address - Street 1:600 N. KOBAYASHI ROAD
Practice Address - Street 2:SUITE 108
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:281-724-0899
Practice Address - Fax:832-632-1437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment