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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