Organization
RAYBURN DIALYSIS LLC
Active
Other names
Midland 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
207 TRADEWINDS BLVD, MIDLAND, TX 79706-2807
(432) 400-4202
(432) 400-4232
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
110112
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027731
KIDNEY PROGRAM
TX
05
—
298424701
—
TX
Enumeration date
12/06/2011
Last updated
04/28/2026
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