NPIMap

Renal Treatment Centers-Southeast, LP.

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

NPI 1366615809 · NPPES record last updated Jul 17, 2025

Key facts

NPI
1366615809
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
008699 (TX)
Legal business name
RENAL TREATMENT CENTERS-SOUTHEAST, LP.
Practice address
2346 Greencrest Blvd
Rockwall, TX 75087-5513
Phone
(972) 722-4781
Fax
(972) 722-4872
NPI assigned
Apr 4, 2008
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

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

Affiliated clinicians 4

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

Medicare Care Compare: Dialysis facility

Listed as
DaVita Rockwall Dialysis Center CCN 672638
Overall star rating
★★★☆☆ 3.0 of 5
Ownership
Profit
Certified
Jan 11, 2010
Medicare certification status
Active (Provider of Services file)
Chain
DaVita
Dialysis stations
17

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
45D1084528Rockwall Dialysis Center
2346 Greencrest Blvd, Rockwall, TX 75087		Certificate of waiverMay 26, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20151230000630 TX Part a Provider - End-Stage Renal Disease Facility (ESRD) 1658555255 Practice locations: Rockwall, TX

National Provider Directory

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

Locations

2346 Greencrest Blvd
Ste 101
Rockwall, TX 75087

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 008699 TX Yes

Addresses

Primary practice location

2346 Greencrest Blvd
Rockwall, TX 75087-5513

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
212773001MedicaidTX

Other names

  • Rockwall Dialysis Center Doing business as

Other providers in Rockwall, TX

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

Sources for this page

Verify at the official NPI Registry.