Organization
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Active
Other names
Gracias 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
12430 STATE HIGHWAY 249 STE H, HOUSTON, TX 77086-3339
(281) 999-0348
(281) 999-0383
Mailing address
5200 VIRGINIA WAY, L & C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110165
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3143620-01
MEDICAID
TX
Enumeration date
08/06/2012
Last updated
03/12/2025
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