Organization
SNG - LUFKIN DIALYSIS CENTER LP
Active
Organization
SNG - LUFKIN DIALYSIS CENTER LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINAM C. MARTIN (CHIEF OPERATIONS OFFICER)
(817) 725-7900
Entity
Organization
Contact information
Practice address
1520 W FRANK AVE, LUFKIN, TX 75904-3314
(936) 238-3583
(936) 238-3592
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 725-7900
(682) 207-1030
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110251
FACILITY LICENSE
TX
05
—
319930901
—
TX
Enumeration date
06/02/2011
Last updated
07/21/2022
Update your record
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