Organization
SAKDC - DAVITA DIALYSIS PARTNERS LP
Active
Other names
Live Oak Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WEY (VP LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
6700 RANDOLPH BLVD, STE 101, LIVE OAK, TX 78233-4222
(210) 590-0103
(210) 590-0813
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181223204
—
TX
Enumeration date
04/12/2006
Last updated
03/19/2025
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