Organization
GOUACHE DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2906 S BAGDAD RD STE 120, LEANDER, TX 78641-3269
(512) 260-4102
(512) 528-1039
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
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
—
3915746-01
—
TX
Enumeration date
11/03/2016
Last updated
02/26/2026
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