Organization
MEMORIAL PERITONEAL DIALYSIS LLC
Active
Organization
MEMORIAL PERITONEAL DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELVA AGRA (CEO)
(909) 450-7159
Entity
Organization
Contact information
Practice address
1170 BLALOCK RD, HOUSTON, TX 77055-7421
(909) 450-7159
Mailing address
1170 BLALOCK RD, HOUSTON, TX 77055-7421
(909) 450-7159
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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