Organization
DIALYSIS CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
4731 NE STALLINGS DR, NACOGDOCHES, TX 75965-1607
(936) 569-9900
(936) 569-9510
Mailing address
4731 NE STALLINGS DR, NACOGDOCHES, TX 75965-1607
(936) 569-9900
(936) 569-9510
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
006731
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127318705
—
TX
05
—
127318708
—
TX
Enumeration date
07/19/2006
Last updated
10/04/2023
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