Provider Demographics
NPI:1093995508
Name:BARLITE SOUTHWEST KIDNEY CENTER
Entity Type:Organization
Organization Name:BARLITE SOUTHWEST KIDNEY CENTER
Other - Org Name:BARLITE SOUTHWEST KIDNEY CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SZEWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-922-3377
Mailing Address - Street 1:7500 BARLITE BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1362
Mailing Address - Country:US
Mailing Address - Phone:210-922-3377
Mailing Address - Fax:210-922-2311
Practice Address - Street 1:7500 BARLITE BLVD STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1362
Practice Address - Country:US
Practice Address - Phone:210-922-3377
Practice Address - Fax:210-922-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
672527Medicare Oscar/Certification