Organization
GERTRUDE DIALYSIS, LLC
Active
Other names
Dialysis Care of Grand Prairie
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
402 N CARRIER PKWY, STE 102, GRAND PRAIRIE, TX 75050-5426
(972) 264-2660
(972) 264-2687
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
—
366094601
—
TX
Enumeration date
04/30/2014
Last updated
03/12/2025
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