Organization
ISD RENAL INC
Active
Organization
ISD RENAL INC
Active
Other names
Riverside Renal Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
3710 FM 1889, ROBSTOWN, TX 78380-5969
(361) 387-0289
(361) 387-0407
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
—
188171602
—
TX
Enumeration date
05/25/2006
Last updated
07/17/2024
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