Organization
BIDWELL DIALYSIS LLC
Active
Other names
Allen 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
201 S JUPITER RD, ALLEN, TX 75002-3035
(469) 342-6709
(469) 342-6398
Mailing address
5200 VIRGINIA WAY, L&C DEPT, 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
—
3398471-01
—
TX
Enumeration date
11/07/2012
Last updated
07/17/2024
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