Organization
UPPER VALLEY DIALYSIS ACCESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN LEE (OWNER)
(956) 600-8899
Entity
Organization
Contact information
Practice address
1203 ST CLAIRE BLVD UNIT 13B, MISSION, TX 78572-8465
(956) 600-8899
(956) 600-7511
Mailing address
5913 LAGO VISTA DR, CORPUS CHRISTI, TX 78414-6335
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/09/2022
Last updated
12/20/2022
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