Organization
INNOVATIVE DIALYSIS SOLUTIONS AT HOME OF DEVINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK NAIL (BUSINESS MANAGER)
(972) 626-1117
Entity
Organization
Contact information
Practice address
11040 W INTERSTATE 10 STE 103, SAN ANTONIO, TX 78230-1080
(830) 541-5372
(830) 267-8110
Mailing address
915 S LAREDO ST STE 200, SAN ANTONIO, TX 78204-3211
(210) 277-1418
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
01
—
110720
ESRD LICENSE
TX
05
—
3929473-01
—
TX
Enumeration date
01/22/2018
Last updated
04/03/2026
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