Organization
MENDOCINO DIALYSIS LLC
Active
Other names
North Conroe Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3211 INTERSTATE 45 N STE 500, CONROE, TX 77304-2187
(936) 756-9400
(936) 756-9450
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3356958-01
—
TX
Enumeration date
05/16/2011
Last updated
07/29/2025
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