Organization
BIOTRONICS KIDNEY CENTER OF BEAUMONT, INC
Active
Other names
Biotronics Kidney Center of Orange, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN M LEE (TREASURER)
(409) 892-1003
Entity
Organization
Contact information
Practice address
1301 MARTIN LUTHER KING JR DR #B, ORANGE, TX 77630-9000
(409) 886-7714
Mailing address
PO BOX 7464, BEAUMONT, TX 77726-7464
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
007139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000HH069Y
BC BS TEXAS
TX
05
—
127317901
—
TX
05
—
127317903
—
TX
Enumeration date
08/17/2006
Last updated
08/28/2012
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