Organization
ELMORE DIALYSIS LLC
Active
Other names
Prosper Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
241 N PRESTON RD, STE A, PROSPER, TX 75078-9896
(972) 347-9268
(972) 347-9863
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
—
4091936-01
—
TX
Enumeration date
01/10/2019
Last updated
05/08/2025
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