Provider Demographics
NPI:1982452975
Name:HEALING DIALYSIS- NW LLC
Entity type:Organization
Organization Name:HEALING DIALYSIS- NW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RATNAKAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:MULPURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-898-1429
Mailing Address - Street 1:200 S RIVERSHIRE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3485
Mailing Address - Country:US
Mailing Address - Phone:832-685-0005
Mailing Address - Fax:832-685-0009
Practice Address - Street 1:724 FM 1960 RD W STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3402
Practice Address - Country:US
Practice Address - Phone:832-685-0005
Practice Address - Fax:832-685-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment