Organization
LONE STAR HOME DIALYSIS LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BALBEER KAUR GODWIN (RN, ADMINISTRATOR)
(281) 799-7089
Entity
Organization
Contact information
Practice address
150 PINE FOREST DR STE 102, CONROE, TX 77384-5302
(936) 271-9442
(800) 395-8956
Mailing address
150 PINE FOREST DR STE 102, CONROE, TX 77384-5302
(936) 271-9442
(800) 395-8956
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
—
017785
TEXAS HEALTH AND HUMAN SERVICES (DADS)
TX
Enumeration date
03/11/2019
Last updated
03/11/2019
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