USRC WEST FORT WORTH DIALYSIS LLC


Address: 1704 S Cherry Ln, Suite 200, White Settlement, TX 76108-3629
Phone: 8173670822

USRC WEST FORT WORTH DIALYSIS LLC (NPI# 1407030364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1407030364
Entity Type Organization
Organization Name USRC WEST FORT WORTH DIALYSIS LLC
Other Organization Name US RENAL CARE TARRANT DIALYSIS WEST FORT WORTH
Practice Address 1704 S Cherry Ln
Suite 200
White Settlement
TX 76108-3629
Mailing Address Po Box 251549
Plano
TX 75025-1500
Practice Telephone 8173670822
Practice Fax Number 8173671520
Mailing Telephone 8709315400
Mailing Fax Number 8709315418
Enumeration Date 2007-12-27
Last Update Date 2020-09-23
Authorized Official Name MR. THOMAS L WEINBERG (SR VP/GENERAL COUNSEL)
Authorized Official Telephone 2147362700
Is Organization Subpart Y
Parent Organization Name US RENAL CARE INC

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QE0700X Clinic/Center
Specialization: End-Stage Renal Disease (ESRD) Treatment
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
TX 213924801 05

Other Provider/Organization Names

Other Name Type Code
US Renal Care Tarrant Dialysis West Fort Worth Doing Business As Name - Organization

Office Location

Street Address 1704 S CHERRY LN
SUITE 200
City WHITE SETTLEMENT
State TX
Zip Code 76108-3629

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1366854267 Alex Bonnette Physical Therapist 9660 Bartlett Cir Ste 708, Fort Worth, TX 76108 2014-05-27
1598196446 Cheryl Dawn Jorgenson Pharmacist 401 South Jim Wright Freeway, Suite 102, Fort Worth, TX 76108 2013-12-03
1760700017 North Texas Ems Ambulance 321 Mesa Grande Dr, Fort Worth, TX 76108 2010-05-12
1801036868 Gary Don Keel Physician Assistant #1 Lockheed Blvd., Lockheed Martin Aeronautics Company, Ft. Worth, TX 76108 2009-03-03
1942420211 Tina Mclendon Specialist/Technologist, Other 332 Memory Dr, Fort Worth, TX 76108 2007-04-27
1700901766 Jennifer E Gamez Nurse Practitioner 12001 S. Freeway Suite 205, Burleson, TX 76108 2007-03-20
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Taxonomy Information

Taxonomy Code 261QE0700X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization End-Stage Renal Disease (ESRD) Treatment

Taxonomy Definition

Definition to come...

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Competitor

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City WHITE SETTLEMENT
Zip Code 76108

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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