NPIMap

Renal Treatment Centers-Southeast, LP.

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Cuero, TX

NPI 1124284500 · NPPES record last updated Mar 25, 2026

Key facts

NPI
1124284500
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
008734 (TX)
Legal business name
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Practice address
1105 E Broadway St
Cuero, TX 77954-2108
Phone
(361) 275-8648
Fax
(361) 275-8691
NPI assigned
Aug 5, 2008
Organization subpart
No

Authorized official

Name
Samuel T Wey
Title
VP Licensure&Certification
Phone
(615) 341-6641

Corporate family (same tax ID) 17

Organizations that report the same tax identification number in the National Provider Directory.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Dialysis facility

Listed as
DaVita Cuero Lakeview Dialysis CCN 452889
Overall star rating
★★☆☆☆ 2.0 of 5
Ownership
Profit
Certified
Jul 20, 2004
Medicare certification status
Active (Provider of Services file)
Chain
DaVita
Dialysis stations
16

Source: Medicare Care Compare. Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1026194Cuero Lakeview Dialysis
1105 East Broadway Street, Cuero, TX 77954		Certificate of waiverMay 27, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151228001107 TX Part a Provider - End-Stage Renal Disease Facility (ESRD) 1658555255 Practice locations: Cuero, TX

National Provider Directory

Tax ID family
Degray Dialysis (137 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 008734 TX Yes

Addresses

Primary practice location

1105 E Broadway St
Cuero, TX 77954-2108

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers

IdentifierTypeStateIssuer
197655701MedicaidTX

Other names

  • Cuero Lakeview Dialysis Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 25, 2026.

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1124284500",
    "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": "1105 E BROADWAY ST",
            "city": "CUERO",
            "state": "TX",
            "postal_code": "779542108",
            "telephone_number": "361-275-8648",
            "fax_number": "361-275-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS-SOUTHEAST, LP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A",
        "authorized_official_last_name": "WEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "T",
        "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": "008734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197655701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cuero Lakeview Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cuero Lakeview Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cuero, TX

All providers in Cuero, TX · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

Sources for this page

Verify at the official NPI Registry.