MEDICARE: USRC TARRANT L P

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	008463	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	HH6158	OTHER	TX	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000885	OTHER	TX	KIDNEY HEALTH CARE

General Provider Information

NPI Number	:	1942256466
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	USRC TARRANT L P

Provider Business Mailing Address
First Line	:	PO BOX 952074
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75395-2074
Country	:	US
Telephone Number	:	870-931-5400
Fax Number	:	870-931-5418

Provider Business Practice Location Address
First Line	:	203 W RANDOL MILL RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5857
Country	:	US
Telephone Number	:	817-275-7787
Fax Number	:	817-275-6561

Authorized Official
Title or Position	:	VP, GENERAL COUNSEL
Name	:	MR. THOMAS L WEINBERG
Credential	:
Telephone Number	:	214-736-2700

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	11/16/2023

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