Organization
TDC-BEDFORD DIALYSIS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KINAM C. MARTIN (CHIEF OPERATIONS OFFICER)
(817) 725-7900
Entity
Organization
Contact information
Practice address
725 N INDUSTRIAL BLVD, STE 100, BEDFORD, TX 76021
(817) 358-4544
(817) 358-4551
Mailing address
1000 W CANNON ST, FORT WORTH, TX 76104-3029
(817) 725-7900
(682) 207-1030
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2017
Last updated
08/21/2017
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