Organization
DVA HEALTHCARE RENAL CARE INC
Active
Organization
DVA HEALTHCARE RENAL CARE INC
Active
Other names
Southwest San Antonio Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WINSTEL (CHIEF ACCOUNTING OFFICER)
(253) 733-4501
Entity
Organization
Contact information
Practice address
1620 SOMERSET RD, SAN ANTONIO, TX 78211-3021
(210) 924-6684
(210) 924-8332
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
(615) 341-6764
(833) 781-6999
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
000025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0210759-01
—
TX
Enumeration date
04/12/2006
Last updated
05/20/2021
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