Egonsa Dialysis LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

EGONSA DIALYSIS LLC

Doing business as

Jackson Meadows Dialysis

Practice address

2500 S Jackson Rd
McAllen, TX 78503-2081

Phone

(956) 664-1723

Fax

(956) 664-1734

NPI assigned

Dec 26, 2018

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Jackson Meadows Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Jackson MeadowsCCN 742536

Overall star rating

2.0 of 5

Ownership

Profit

Certified

Apr 17, 2019

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

21

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

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Phyo Kidney Care PA

  • Nephrology Physician
  • McAllen, TX
  • NPI 1093220113

  Member Of

  NPD member
• Renal Treatment Centers-Southeast, LP.

  dba Donna Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Donna, TX
  • NPI 1902353543

  Member Of

  NPD member

Locations

Affiliated clinicians 2

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

• Salil Mangi, MD

  • Nephrology Physician
  • McAllen, TX
  • NPI 1881693695

  Dialysis facility

  Care Compare affiliation Name & address match
• Nyan Wai Phyo, MD

  • Nephrology Physician
  • McAllen, TX
  • NPI 1669786042

  Dialysis facility

  Care Compare affiliation Name & address match

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774396800000",
    "number": "1295207660",
    "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": "2500 S JACKSON RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785032081",
            "telephone_number": "956-664-1723",
            "fax_number": "956-664-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGONSA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-26",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4009771-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Meadows Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jackson Meadows Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eduardo J Mariel Mdpa
• Edward H Tan M D P a
• Roy Dewayne Edwards, D.O.
• Efrailan Marin (Alpha Medical Supplies)
• Obiora Emmaunel Egbo, MD
• Luis E Eguia, MD
• Eighteen Lac, Inc (Divinity Home Healthcare)
• El Jardin Provider Services, LLC.
• Loubna El Kettani
• El Oro del Pueblo Services, Inc. (El Oro del Pueblo Adult Day Care 1)

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in McAllen, TX
• Providers in McAllen, TX by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.