Renal Treatment Centers Southeast LP

Primary specialty

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

License

110012 Issued in TX

Legal business name

RENAL TREATMENT CENTERS SOUTHEAST LP

Doing business as

Benbrook Dialysis

Practice address

6260 Southwest Blvd
Benbrook, TX 76109-6906

Phone

(817) 731-3652

Fax

(817) 731-4655

NPI assigned

Jan 16, 2009

Organization subpart

No

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

Authorized official

Name

James K Hilger

Title

Chief Accounting Officer

Phone

(253) 382-1919

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Benbrook Dialysis Doing business as

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378339200000",
    "number": "1811134547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 VIRGINIA WAY",
            "address_2": "L&C DEPT 4TH FLOOR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277569",
            "telephone_number": "615-320-4550",
            "fax_number": "866-500-8578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 SOUTHWEST BLVD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761096906",
            "telephone_number": "817-731-3652",
            "fax_number": "817-731-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAL TREATMENT CENTERS SOUTHEAST LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2013-09-05",
        "status": "A",
        "authorized_official_last_name": "HILGER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CHIEF ACCOUNTING OFFICER",
        "authorized_official_telephone_number": "253-382-1919"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "110012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280464301",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KIDNEY HEALTH CARE",
            "identifier": "026493",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benbrook Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sydney Faith Rangel, OTR/L
• Jennifer Ann Ratliff, O.D.
• Rayseq, PA (Benbrook Family Chiropractic & Wellness)
• Candice Nicole Reed, AUD
• Rely Dental Centers PC
• Kasey Renfro
• Chandler Brendan Rice
• Sarah Riojas
• Azuany Rios
• Mallori Jade Ritchey

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Benbrook, TX
• Providers in Benbrook, 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 Sep 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.