Organization Name: | USRC SA TRI COUNTY LLC |
NPI Number: | 1477512895 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS L WEINBERG (VP, GENERAL COUNSEL) |
Mailing Address: | 14832 Main St Lytle |
State: | TX US |
Postal Code: | 780529641 |
Phone Number: | 8307725784 |
Fax Number: | 8307725793 |
NPI Enumeration Date: | 03/23/2006 |
NPI Last Update Date: | 01/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | 008135 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |