NPIMap

Organization Active NPI

Houston Kidney Center - Total Renal Care Integrated Service Network LP

Doing business as Houston Kidney Center Cypress Station

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Houston, TX
National Provider Identifier
1871556662
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
110175 Issued in TX
Legal business name
HOUSTON KIDNEY CENTER - TOTAL RENAL CARE INTEGRATED SERVICE NETWORK LP
Doing business as
Houston Kidney Center Cypress Station
Practice address
72 Cypress Creek Pkwy
Houston, TX 77090-3531
Phone
(281) 580-6157
Fax
(281) 580-6850
NPI assigned
Apr 11, 2006
Last updated
Oct 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 110175 TX Primary

Addresses

Primary practice location

72 Cypress Creek Pkwy
Houston, TX 77090-3531

Mailing address

5200 Virginia Way
L&C Dept
Brentwood, TN 37027-7569

Other identifiers 1

IdentifierTypeStateIssuer
094317701MedicaidTX

Other names 1

  • Houston Kidney Center Cypress Station Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040427001677 TX Part A Provider - End-Stage Renal Disease Facility (ESRD) 5496668279 Practice locations: Houston, TX

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Houston Kidney Center - Total Renal Care Integrated Service Network LP4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1871556662",
    "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": "72 CYPRESS CREEK PKWY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903531",
            "telephone_number": "281-580-6157",
            "fax_number": "281-580-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSTON KIDNEY CENTER - TOTAL RENAL CARE INTEGRATED SERVICE NETWORK LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "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": "110175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094317701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Houston Kidney Center Cypress Station",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Houston Kidney Center Cypress Station",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.