Organization
PHOENIX DIALYSIS LLC
Active
Organization
PHOENIX DIALYSIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN DAWSON (CEO)
(979) 985-3700
Entity
Organization
Contact information
Practice address
407 E. SOUTH ST., WEIMAR, TX 78962
(979) 985-3700
(979) 859-7154
Mailing address
PO BOX 127, FRESNO, TX 77545-0127
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110457
TX
Other
Enumeration date
12/28/2016
Last updated
03/01/2018
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