Organization
RENAL CENTER OF TYLER, LP, LLLP
Active
Other names
Renal Center Of Tyler
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
510 S SOUTHWEST LOOP 323, STE 580, TYLER, TX 75702-7693
(903) 596-0102
(903) 596-9704
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
007969
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162343103
—
TX
Enumeration date
07/12/2006
Last updated
03/14/2025
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