Organization
DVA RENAL HEALTHCARE INC
Active
Other names
Rock Prairie Road 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
1724 BIRMINGHAM RD, STE 101, COLLEGE STATION, TX 77845-4063
(979) 704-6903
(979) 704-6906
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
110450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174007802
—
TX
Enumeration date
04/12/2006
Last updated
02/16/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us