Organization
RENAL TREATMENT CENTERS SOUTHEAST LP
Active
Other names
Benbrook Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K HILGER (CHIEF ACCOUNTING OFFICER)
(253) 382-1919
Entity
Organization
Contact information
Practice address
6260 SOUTHWEST BLVD, BENBROOK, TX 76109-6906
(817) 731-3652
(817) 731-4655
Mailing address
5200 VIRGINIA WAY, L&C DEPT 4TH FLOOR, BRENTWOOD, TN 37027-7569
(615) 320-4550
(866) 500-8578
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
110012
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026493
KIDNEY HEALTH CARE
TX
05
—
280464301
—
TX
Enumeration date
01/16/2009
Last updated
09/05/2013
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