SNG - SAN AUGUSTINE DIALYSIS CENTER LP NPI 1619230075

NPI Information

NPI: 1619230075
Provider Name: SNG - SAN AUGUSTINE DIALYSIS CENTER LP
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 45D1093138

Address:
403 N MILAM ST
SAN AUGUSTINE, TX
ZIP 75972
Phone: (936) 275-3600
Get Directions

SNG - SAN AUGUSTINE DIALYSIS CENTER LP is an end-stage renal disease (esrd) treatment clinic center in San Augustine, TX. SNG - SAN AUGUSTINE DIALYSIS CENTER LP NPI is 1619230075. The provider is registered as an organization entity type.

The provider's business location address is:

403 N MILAM ST
SAN AUGUSTINE, TX
ZIP 75972-228
Phone: (936) 275-3600
Fax: (936) 275-3602

The provider's authorized official is Kinam C. Martin .
The authorized official title is Chief Operations Officer and has the following contact phone number (817) 725-7900.

The CLIA number assigned to this NPI record is 45D1093138 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/20/2012 and was last updated on 7/21/2022.

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			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	Other Provider Identifier Issuer
1	319859001	MEDICAID	TEXAS
2	110114	OTHER	TEXAS	FACILITY LICENSE

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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