Organization
DVA RENAL HEALTHCARE INC
Active
Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Briarcrest 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
1640 BRIARCREST DR STE 100, BRYAN, TX 77802-2933
(979) 260-4908
(979) 268-5890
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
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
—
094256701
—
TX
01
—
953372911125
TRICARE
—
Enumeration date
04/10/2006
Last updated
12/19/2024
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