Basic Information
Provider Information
NPI: 1467513051
EntityType: 2
ReplacementNPI:  
OrganizationName: RENAL SOLUTIONS, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2756 W T C JESTER BLVD
Address2:  
City: HOUSTON
State: TX
PostalCode: 770187003
CountryCode: US
TelephoneNumber: 7136809056
FaxNumber: 7136809310
Practice Location
Address1: 2756 W T C JESTER BLVD
Address2:  
City: HOUSTON
State: TX
PostalCode: 770187003
CountryCode: US
TelephoneNumber: 7136809056
FaxNumber: 7136809310
Other Information
ProviderEnumerationDate: 12/13/2006
LastUpdateDate: 03/24/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: DEGUZMAN
AuthorizedOfficialFirstName: MARIE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: ADMINISTRATOR
AuthorizedOfficialTelephone: 7136809056
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: R.N.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QE0700X007993TXY Ambulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment

ID Information
IDTypeStateIssuerDescription
16708120105TX MEDICAID


Home