Alamosa Dialysis LLC

Primary specialty

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

License

008733 Issued in TX

Legal business name

ALAMOSA DIALYSIS LLC

Doing business as

Port Lavaca Dialysis

Practice address

1300 N Virginia St
Ste 102
Port Lavaca, TX 77979-2512

Phone

(361) 552-3800

Fax

(361) 552-8703

NPI assigned

Sep 23, 2008

Last updated

Apr 21, 2025By the provider in NPPES

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

• Port Lavaca Dialysis Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

DaVita Port Lavaca DialysisCCN 672595

Overall star rating

3.0 of 5

Ownership

Profit

Certified

Oct 1, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Chain

DaVita

Dialysis stations

10

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.

• Bainbridge Dialysis LLC

  dba Central Fort Worth Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Fort Worth, TX
  • NPI 1699041152

  Member Of

  NPD member
• Renal Treatment Centers-Southeast, LP.

  dba Barbour County Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Eufaula, AL
  • NPI 1326583188

  Member Of

  NPD member

Affiliated clinicians 1

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

• George Amechi Osuchukwu, M.D.

  • Nephrology Physician
  • Victoria, TX
  • NPI 1962612887

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1801046255",
    "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": "1300 N VIRGINIA ST",
            "address_2": "STE 102",
            "city": "PORT LAVACA",
            "state": "TX",
            "postal_code": "779792512",
            "telephone_number": "361-552-3800",
            "fax_number": "361-552-8703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAMOSA DIALYSIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-23",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "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": "TX",
            "license": "008733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025991-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Port Lavaca Dialysis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Port Lavaca Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deri Adair, LPC
• Nneoma Joy Agwu
• Andrew K Seamans DDS Inc
• Onyeka Arinze, RPH
• Richard Arroyo-Diaz, MD
• Amber Ather, DDS
• B.a.T.E.S. Place, Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Port Lavaca, TX
• Providers in Port Lavaca, 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 Apr 21, 2025; 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.