Organization
TARLETON DIALYSIS LLC
Active
Other names
Canutillo Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
7251 S DESERT BLVD, CANUTILLO, TX 79835-2200
(915) 877-4907
(915) 877-4912
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3959777-01
—
TX
Enumeration date
05/24/2018
Last updated
12/21/2023
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