Organization
ISD CORPUS CHRISTI LLC
Active
Organization
ISD CORPUS CHRISTI LLC
Active
Other names
Greenwood Holly Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1533 HOLLY RD, CORPUS CHRISTI, TX 78417-2010
(361) 850-7300
(361) 850-7305
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
008662
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2117814-01
—
TX
Enumeration date
12/14/2007
Last updated
02/18/2025
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