Provider Demographics
NPI:1053636191
Name:ADVANTAGE RENAL CARE LLC
Entity Type:Organization
Organization Name:ADVANTAGE RENAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ISBELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-466-8237
Mailing Address - Street 1:3169 CALLE MARAVILLOSA
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1240
Mailing Address - Country:US
Mailing Address - Phone:956-466-8237
Mailing Address - Fax:888-943-2228
Practice Address - Street 1:1601 E ALTON GLOOR BLVD
Practice Address - Street 2:STE 105
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3902
Practice Address - Country:US
Practice Address - Phone:956-466-8237
Practice Address - Fax:888-943-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment