TUMALO DIALYSIS LLC (NPI# 1699046771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699046771 |
| Entity Type | Organization |
| Organization Name | TUMALO DIALYSIS LLC |
| Other Organization Name | SAN ANGELO DIALYSIS |
| Practice Address |
3518 Knickerbocker Rd San Angelo TX 76904-7611 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 3259496035 |
| Practice Fax Number | 3259496791 |
| Mailing Telephone | 6153416764 |
| Mailing Fax Number | 8337816999 |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2020-09-10 |
| Authorized Official Name | JOHN WINSTEL (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334501 |
| Is Organization Subpart | N |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 3347403-02 | 05 |
| Other Name | Type Code |
|---|---|
| San Angelo Dialysis | Doing Business As Name - Organization |
| Street Address |
3518 KNICKERBOCKER RD |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904-7611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952589665 | Angelo Kidney Connection, Pllc | Clinic/Center | 2901 Sherwood Way, Suite 100, San Angelo, TX 76901-3586 | 2008-02-05 |
| 1881118693 | Fresenius Kidney Care Concho Valley, LLC | Clinic/Center | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2017-08-02 |
| 1336386028 | Shannon Medical Center | Clinic/Center | 2018 Pulliam St, San Angelo, TX 76905-5148 | 2009-01-16 |
| 1609860485 | West Texas Renal Care Center Inc | Clinic/Center | 3501 Executive Dr, San Angelo, TX 76904-6883 | 2005-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942801931 | Usrc Mckinney, LLC | Clinic/Center | 1434 N Central Expy Ste 116, Mckinney, TX 75070-3108 | 2020-11-05 |
| 1437756772 | Usrc Bluebonnet, LLC | Clinic/Center | 1902 Windsor Pl, Ste 100, Fort Worth, TX 76110-1866 | 2020-10-08 |
| 1609473941 | Usrc Bluebonnet Home, LLC | Clinic/Center | 1902 Windsor Pl Ste 202, Fort Worth, TX 76110-1866 | 2020-10-08 |
| 1982210050 | Usrc Stephenville LLC | Clinic/Center | 942 Bluebonnet Dr, Stephenville, TX 76401-1764 | 2020-09-23 |
| 1801402979 | Usrc Garland LLC | Clinic/Center | 219 W Kingsley Rd Ste 316, Garland, TX 75041-3434 | 2020-09-23 |
| 1003422171 | Usrc Dialysis At Home West LLC | Clinic/Center | 12011 State Highway 151 Ste 222, San Antonio, TX 78251-1230 | 2020-09-23 |
| 1477165462 | Fresenius Medical Care South Lewisville, LLC | Clinic/Center | 101 E Southwest Pkwy Ste 110, Lewisville, TX 75067-8753 | 2020-08-20 |
| 1598383259 | Dialysis Clinic Inc. | Clinic/Center | 6146 Wurzbach Road, San Antonio, TX 78238 | 2020-07-09 |
| 1891312559 | Usrc Houston Newco Home LLC | Clinic/Center | 2000 Crawford St Ste 777, Houston, TX 77002-9006 | 2020-06-29 |
| 1427671502 | Usrc Plano Dexter, LLC | Clinic/Center | 4708 Dexter Dr, Plano, TX 75093-5288 | 2020-05-22 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
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| 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.