Organization
LAKE JACKSON DIALYSIS AND KIDNEY CENTER, LTD, LLP
Active
Other names
Angleton Kidney Center
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH GOLD MD (MEDICAL DIRECTOR)
(979) 864-4330
Entity
Organization
Contact information
Practice address
102 E HOSPITAL DR, ANGLETON, TX 77515-4112
(979) 864-4330
(979) 864-3560
Mailing address
PO BOX 4639, HOUSTON, TX 77210-4639
(979) 864-4330
(979) 864-3560
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
008264
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182096102
—
TX
Enumeration date
02/06/2007
Last updated
08/10/2009
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