Basic Information
| Provider Information | |||||||||
| NPI: | 1811290109 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROMANO WOODS DIALYSIS CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8700 S GESSNER DR STE 300 | ||||||||
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| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770742916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137747676 | ||||||||
| FaxNumber: | 7137740432 | ||||||||
| Practice Location | |||||||||
| Address1: | 16910 MATHIS CHURCH RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770903710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2818936300 | ||||||||
| FaxNumber: | 2818936366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/08/2010 | ||||||||
| LastUpdateDate: | 12/08/2010 | ||||||||
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| AuthorizedOfficialLastName: | TIMMONS | ||||||||
| AuthorizedOfficialFirstName: | LORI | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9798644330 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | RN, BSN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0700X | 008722 | TX | Y | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment |
No ID Information.