Organization
DALLAS-FORT WORTH NEPHROLOGY LP
Active
Other names
Grapevine Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
1651 W NORTHWEST HWY, GRAPEVINE, TX 76051-3100
(817) 251-0675
(817) 421-0417
Mailing address
5200 VIRGINIA WAY, L&C DEPT, 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
008284
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1817645-02
—
TX
Enumeration date
09/12/2006
Last updated
01/30/2024
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