Organization
DOUGLAS PARK I LTD
Active
Organization
DOUGLAS PARK I LTD
Active
Other names
Midland Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS PARK M.D. (MEDICAL DIRECTOR)
(432) 687-4044
Entity
Organization
Contact information
Practice address
705 W WADLEY AVE, MIDLAND, TX 79705-5351
(432) 687-1201
(432) 687-5008
Mailing address
705 W WADLEY AVE, MIDLAND, TX 79705-5351
(432) 687-1201
(432) 687-5008
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
006898
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH6176
BC/BS
TX
Enumeration date
12/02/2005
Last updated
02/14/2008
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