Organization
AMERI-TECH KIDNEY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEIF GUTTORMSEN (ADMINISTRATOR)
(817) 265-7115
Entity
Organization
Contact information
Practice address
1600 CENTRAL DR, SUITE 130, BEDFORD, TX 76022-6000
(817) 545-8044
(817) 283-0612
Mailing address
1138 S BOWEN RD, ARLINGTON, TX 76013-2204
(817) 265-7115
(817) 801-7386
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
000222
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1127359-02
—
TX
Enumeration date
09/21/2006
Last updated
12/03/2013
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