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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