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NPI Code Detail

MEDICARE: TERRELL DIALYSIS CENTER, L.L.C.

MEDICARE: TERRELL DIALYSIS CENTER, L.L.C.
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

General Provider Information

NPI Number : 1780796672
Entity Type Code : Organization
Provider Name (Legal Business Name) : TERRELL DIALYSIS CENTER, L.L.C.
Provider Business Mailing Address
First Line : 2213 OLD KEMP HWY
Second Line :
City : KAUFMAN
State : TX
Zip : 75142-3658
Country : US
Telephone Number : 972-932-4846
Fax Number : 972-932-4909
Provider Business Practice Location Address
First Line : 2213 OLD KEMP HWY
Second Line :
City : KAUFMAN
State : TX
Zip : 75142-3658
Country : US
Telephone Number : 972-932-4846
Fax Number : 972-932-4909
Authorized Official
Title or Position : VICE PRESIDENT
Name : BARRY L. BLANTON
Credential :
Telephone Number : 781-699-9000
Provider Enumeration Date : 08/31/2006
Last Update Date : 10/17/2023

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Directions to “TERRELL DIALYSIS CENTER, L.L.C. ” Practice Location

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