Active NPI
Renal Center of Tyler, LP, LLLP
Doing business as Renal Center Of Tyler
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Tyler, TX
National Provider Identifier
1124043187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- License
- 007969
- Legal business name
- RENAL CENTER OF TYLER, LP, LLLP
- Doing business as
- Renal Center Of Tyler
- Practice address
- 510 S Southwest Loop 323
Ste 580
Tyler, TX 75702-7693 - Phone
- (903) 596-0102
- Fax
- (903) 596-9704
- NPI assigned
- Jul 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Samuel Wey
- Title
- VP, Licensure & Certification
- Phone
- (615) 341-6641
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| End-Stage Renal Disease (ESRD) Treatment Clinic/Center | 261QE0700X | 007969 | TX | Primary |
Addresses
Primary practice location
510 S Southwest Loop 323
Ste 580
Tyler, TX 75702-7693
Mailing address
5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162343103 | Medicaid | TX |
Other names 1
- Renal Center Of Tyler
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030624000033 | TX | Part A Provider - End-Stage Renal Disease Facility (ESRD) | 1153231196 | Practice locations: Tyler, TX |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Lehighton Dialysis
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Lehighton, PA
- NPI 1598727372
Member Of
Locations
510 Ssw Loop 323
Ste 580
Tyler, TX 75702
Phone (903) 596-0102
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nephrology Physician
- Tyler, TX
- NPI 1972642965
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1780876800000",
"number": "1124043187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 VIRGINIA WAY",
"address_2": "L&C DEPT",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370277569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "510 S SOUTHWEST LOOP 323",
"address_2": "STE 580",
"city": "TYLER",
"state": "TX",
"postal_code": "757027693",
"telephone_number": "903-596-0102",
"fax_number": "903-596-9704"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RENAL CENTER OF TYLER, LP, LLLP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-12",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A",
"authorized_official_last_name": "WEY",
"authorized_official_first_name": "SAMUEL",
"authorized_official_title_or_position": "VP, LICENSURE & CERTIFICATION",
"authorized_official_telephone_number": "615-341-6641"
},
"taxonomies": [
{
"code": "261QE0700X",
"taxonomy_group": "",
"desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
"state": "TX",
"license": "007969",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162343103",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Renal Center Of Tyler",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Tyler, TX
- Remm Counseling PLLC
- Renal Care Group Texas, Inc. (Fresenius Medical Care Tyler Home Dialysis)
- Renal Care Group Texas, Inc. (West Tyler Dialysis)
- Renal Care Group Texas, Inc. (Southeast Tyler)
- Renal Care Group Texas, Inc. (Watson Wise Dialysis Center)
- Renal Center of Waterton, LLLP (Renal Center of Waterton)
- Mark B Renfro, MD
- Devyn Paige Renfroe, PTA
- Haleigh Nicole Renfroe, DDS
- Julee G Renfroe, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.