Organization
TOTAL RENAL CARE INC
Active
Other names
Northeast Texas Dialysis
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP LICENSURE&CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
413B LOOP 59, ATLANTA, TX 75551-2015
(903) 799-5843
(903) 796-1137
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
110119
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311327601
—
TX
Enumeration date
12/20/2011
Last updated
11/14/2024
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