Organization
MADISON DIALYSIS LLC
Active
Other names
Balcones 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
11150 RESEARCH BLVD STE 201, AUSTIN, TX 78759-5242
(512) 342-1097
(512) 342-1967
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3840829-01
—
TX
Enumeration date
04/20/2015
Last updated
10/02/2024
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