Organization
COUNTY OF LA SALLE
Active
Organization
COUNTY OF LA SALLE
Active
Other names
La Salle Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
LEODORO MARTINEZ III (COUNTY JUDGE)
(830) 483-5139
Entity
Organization
Contact information
Practice address
627 N BAYLOR ST, COTULLA, TX 78014
(830) 483-5260
(830) 483-5865
Mailing address
300 SANTANA ROW STE 300, SAN JOSE, CA 95128-2424
(669) 236-5953
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
01
—
110680
TX HHSC STATE LICENSE
TX
Enumeration date
05/25/2023
Last updated
05/25/2023
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