Organization
RENAL CENTER OF KELLER, LLC
Active
Other names
Renal Center of Keller
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
10708 VICTORIA ASH DR, FORT WORTH, TX 76244-6392
(817) 431-6533
(817) 431-6543
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
05
—
3439457-01
—
TX
Enumeration date
08/07/2013
Last updated
10/03/2024
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