MEDICARE: SATELLITE DIALYSIS WINDSOR, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QE0700X	End-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number	:	1205613064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SATELLITE DIALYSIS WINDSOR, LLC

Provider Business Mailing Address
First Line	:	5851 LEGACY CIR STE 900
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5982
Country	:	US
Telephone Number	:	214-736-2663
Fax Number	:

Provider Business Practice Location Address
First Line	:	8911 LAKEWOOD DR STE 16
Second Line	:
City	:	WINDSOR
State	:	CA
Zip	:	95492-7857
Country	:	US
Telephone Number	:	707-836-1091
Fax Number	:	707-831-1862

Authorized Official
Title or Position	:	CHAIRMAN & PRESIDENT
Name	:	THOMAS L WEINBERG
Credential	:
Telephone Number	:	214-736-2700

Provider Enumeration Date	:	09/13/2023
Last Update Date	:	04/24/2025

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