Organization
DIALYSIS CLINIC INC.
Active
Other names
Children's Dialysis Clinic of Central Texas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN SCHULTZ (PRESIDENT)
(615) 327-3061
Entity
Organization
Contact information
Practice address
1301 BARBARA JORDAN BLVD, SUITE 103, AUSTIN, TX 78723-3077
(512) 524-4213
(512) 524-4223
Mailing address
1301 BARBARA JORDAN BLVD., SUITE 103, AUSTIN, TX 78723-3054
(512) 524-4213
(512) 524-4223
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
007823
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004201430
—
CT
05
—
1273187-06
—
TX
05
—
1273187-07
—
MO
Enumeration date
07/20/2006
Last updated
10/04/2023
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