Organization
WEST TEXAS RENAL CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE F MONTOYA JR. M.D. (CEO)
(325) 653-6773
Entity
Organization
Contact information
Practice address
3501 EXECUTIVE DR, SAN ANGELO, TX 76904-6883
(325) 949-5081
Mailing address
136 E CONCHO AVE, SAN ANGELO, TX 76903-5947
(325) 653-6773
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
006902
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094270801
—
TX
01
—
HH6151
BCBS
TX
Enumeration date
09/07/2005
Last updated
02/03/2012
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