MEMORIAL HEALTH SYSTEM OF EAST TEXAS NPI 1437119922

NPI Information

NPI: 1437119922
Provider Name: MEMORIAL HEALTH SYSTEM OF EAST TEXAS

Doing Business As: HENDERSON KIDNEY DISEASE CTR

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
1201 W FRANK AVE
LUFKIN, TX
ZIP 75904
Phone: (936) 634-8111
Get Directions

MEMORIAL HEALTH SYSTEM OF EAST TEXAS is an end-stage renal disease (esrd) treatment clinic center in Lufkin, TX. MEMORIAL HEALTH SYSTEM OF EAST TEXAS NPI is 1437119922. The provider is registered as an organization entity type.
The provider Is Doing Business As Henderson Kidney Disease Ctr.

The provider's business location address is:

1201 W FRANK AVE
LUFKIN, TX
ZIP 75904-357
Phone: (936) 634-8111
Fax: (936) 639-7827

The provider's authorized official is Joe Freudenberger .
The authorized official title is Ceo and has the following contact phone number (936) 634-8111.

The enumeration date for this NPI number is 3/27/2006 and was last updated on 7/1/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	000129	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	452345	MEDICARE ID-TYPE UNSPECIFIED
2	121703605	MEDICAID	TEXAS
3	1437119922	MEDICARE OSCAR/CERTIFICATION	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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