Organization
BANFORT DIALYSIS LLC
Active
Organization
BANFORT DIALYSIS LLC
Active
Other names
Pflugerville Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (SR DIRECTOR LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
2606 W PECAN ST, BLDG 3 STE 300, PFLUGERVILLE, TX 78660-1917
(512) 990-7785
(512) 990-7811
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
(615) 320-4224
(800) 293-4707
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
—
3909798-01
—
TX
Enumeration date
12/22/2017
Last updated
09/12/2023
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