Organization
SPACE CITY DIALYSIS CENTER LLC
Active
Organization
SPACE CITY DIALYSIS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA ANNE BRADY (CHIEF NURSING OFFICER)
(208) 371-7878
Entity
Organization
Contact information
Practice address
6518 MEMORIAL DR, TEXAS CITY, TX 77591-4056
(409) 965-0318
(409) 965-0319
Mailing address
6518 MEMORIAL DR, TEXAS CITY, TX 77591-4056
(409) 965-0318
(409) 965-0319
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
05
—
332410501
—
TX
Enumeration date
10/31/2011
Last updated
01/10/2023
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