Organization
MISSION DIALYSIS SERVICES LLC
Active
Organization
MISSION DIALYSIS SERVICES LLC
Active
Parent organization
PHYSICIANS DIALYSIS DENTON
Other names
Physicians Dialysis Denton
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICIANS DIALYSIS DENTON
Authorized official
MISS GARY J BOOTH (CEO)
(305) 651-3261
Entity
Organization
Contact information
Practice address
3305 UNICORN LAKE BLVD, DENTON, TX 76210-0102
(940) 387-4592
Mailing address
19559 NE 10TH AVE, NORTH MIAMI BEACH, FL 33179-3501
(305) 651-3261
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110282
TX
Other
Enumeration date
11/04/2016
Last updated
11/04/2016
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