Organization
HEADLANDS DIALYSIS, LLC
Active
Other names
Hulen 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
5832 S HULEN ST, FORT WORTH, TX 76132-2684
(817) 370-7642
(817) 370-7774
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
01
—
110287
STATE LICENSE
TX
05
—
366417901
—
TX
Enumeration date
08/27/2014
Last updated
04/23/2025
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