Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Island 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
5920 BROADWAY ST, GALVESTON, TX 77551-4305
(409) 740-1109
(409) 740-1464
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
008180
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121823202
—
TX
Enumeration date
04/11/2006
Last updated
03/05/2026
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