Memorial Dialysis Center LP

Primary specialty

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

License

008214 Issued in TX

Legal business name

MEMORIAL DIALYSIS CENTER LP

Practice address

11621 Katy Fwy
Houston, TX 77079-1801

Phone

(281) 558-5702

Fax

(281) 597-8377

NPI assigned

Apr 11, 2006

Organization subpart

No

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

Authorized official

Name

Samuel T Wey

Title

VP Licensure&Certification

Phone

(615) 341-6641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Memorial Dialysis Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Memorial Dialysis CenterCCN 452755

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Apr 24, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

26

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.

• Total Renal Care Texas Limited Partnership

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lancaster, TX
  • NPI 1760445548

  Member Of

  NPD member
• Total Renal Care Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Burlington, WA
  • NPI 1932595584

  Member Of

  NPD member

Locations

Affiliated clinicians 4

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

• Rahul Prakash, MD

  • Nephrology Physician
  • Katy, TX
  • NPI 1902846108

  Dialysis facility

  Care Compare affiliation Name & address match
• Redentor Antonio Roy, M.D.

  • Nephrology Physician
  • Houston, TX
  • NPI 1982674883

  Dialysis facility

  Care Compare affiliation Name & address match
• Vijayaprakash Sreenarasimhaiah, M.D.

  • Nephrology Physician
  • Houston, TX
  • NPI 1427028372

  Dialysis facility

  Care Compare affiliation Name & address match
• Ariel M Velasco, M.D.

  • Nephrology Physician
  • Houston, TX
  • NPI 1851361703

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1720041460",
    "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": "11621 KATY FWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770791801",
            "telephone_number": "281-558-5702",
            "fax_number": "281-597-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL DIALYSIS CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "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": "008214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094305201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Memorial Dental Associates
• Memorial Dental Associates PLLC
• Memorial Dental Care, PLLC
• Memorial Dentistry for Kids PLLC
• Memorial Dentists, PC
• Memorial Electrodiagnostics, LLC
• Memorial Emergency Center, LLC
• Memorial Emergency Physicians P.a.
• Memorial Endocrinology and Diabetes
• Memorial Endoscopy Center, LP

• All providers in Houston, TX
• 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 Nov 6, 2024; 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.