Organization
DVA HEALTHCARE RENAL CARE, INC.
Active
Other names
Weatherford Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS O. USILTON JR. (GROUP VICE PRESIDENT)
(770) 541-7922
Entity
Organization
Contact information
Practice address
523 W 7TH ST, WEATHERFORD, TX 76086-1536
(817) 599-9570
(817) 599-9575
Mailing address
5200 VIRGINIA WAY, STE. 400 L&C, BRENTWOOD, TN 37027-7569
(615) 320-4435
(303) 209-7821
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
000072
TX
Other
Enumeration date
04/12/2006
Last updated
08/22/2020
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