Usrc Sa Tri County LLC

Primary specialty

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

License

008135 Issued in TX

Legal business name

USRC SA TRI COUNTY LLC

Practice address

19910 Interstate 35 S Ste 101
Lytle, TX 78052-3547

Phone

(830) 772-5784

NPI assigned

Mar 23, 2006

Organization subpart

Yes

Parent organization

US RENAL CARE INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas L Weinberg

Title

VP, General Counsel

Phone

(214) 736-2700

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Usrc Tri-County DialysisCCN 672507

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Feb 18, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Chain

US Renal Care, Inc.

Dialysis stations

25

Part of

US Renal Care Inc

Locations

Affiliated clinicians 3

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

• Reza Abbas Ali, MD

  • Nephrology Physician
  • San Antonio, TX
  • NPI 1669625448

  Dialysis facility

  Care Compare affiliation Name & address match
• Bushra Yusuf, M.D

  • Nephrology Physician
  • San Antonio, TX
  • NPI 1104091982

  Dialysis facility

  Care Compare affiliation Name & address match
• Naushad Zafar, M.D.

  • Nephrology Physician
  • San Antonio, TX
  • NPI 1396729083

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1477512895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 251549",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750251500",
            "telephone_number": "870-931-5400",
            "fax_number": "870-931-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19910 INTERSTATE 35 S STE 101",
            "city": "LYTLE",
            "state": "TX",
            "postal_code": "780523547",
            "telephone_number": "830-772-5784"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14832 Main St",
            "address_purpose": "LOCATION",
            "city": "Lytle",
            "state": "TX",
            "postal_code": "780529641",
            "country_code": "US",
            "telephone_number": "830-772-5784",
            "fax_number": "830-772-5793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14832 Main St",
            "address_purpose": "LOCATION",
            "city": "Lytle",
            "state": "TX",
            "postal_code": "780529641",
            "country_code": "US",
            "telephone_number": "830-772-5784",
            "fax_number": "830-772-5793",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "USRC SA TRI COUNTY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "US RENAL CARE INC",
        "enumeration_date": "2006-03-23",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "WEINBERG",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP, GENERAL COUNSEL",
        "authorized_official_telephone_number": "214-736-2700"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "008135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171298602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "HH6475",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIDNEY HEALTH CARE",
            "identifier": "018153",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171298601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francisca Tamayo, MA CCC/SLP
• Jack Kennedy Taylor, LPC
• Melanie Prieto Trevino, LPC
• Tri-County PHC
• Tammy Turner, LBSW-MSW
• Carmen Y Vasquez Rodriguez, EIS
• Tawnya Ann Vogelsong, OT
• Deborah Wagner, M.S. CCC-SLP
• Robert Lynn Wilson, SLP
• Kathryn Woods, EIS

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Lytle, TX
• Providers in Lytle, 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 17, 2018; 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.