Phoenix Dialysis LLC

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

NPI 1710422845 · NPPES record last updated Mar 1, 2018

Key facts

NPI
1710422845
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
License
110457 (TX)
Legal business name
PHOENIX DIALYSIS LLC
Practice address
407 E. South St.
Weimar, TX 78962
Phone
(979) 985-3700
Fax
(979) 859-7154
NPI assigned
Dec 28, 2016
Organization subpart
No

Authorized official

Name
Autumn Dawson
Title
Ceo
Phone
(979) 985-3700

National Provider Directory

Locations

407 E South St
Weimar, TX 78962
Phone (979) 725-2266

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 110457 TX Yes

Addresses

Primary practice location

407 E. South St.
Weimar, TX 78962

Mailing address

PO Box 127
Fresno, TX 77545-0127

Other providers in Weimar, TX

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

Sources for this page

Verify at the official NPI Registry.