Provider Demographics
NPI:1467810325
Name:DSI SOUTHEAST SAN ANTONIO, LLC
Entity Type:Organization
Organization Name:DSI SOUTHEAST SAN ANTONIO, LLC
Other - Org Name:U. S. RENAL CARE SOUTHEAST SAN ANTONIO DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:YALOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-777-8200
Mailing Address - Street 1:424 CHURCH ST
Mailing Address - Street 2:SUITE 1900
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-2301
Mailing Address - Country:US
Mailing Address - Phone:615-777-8200
Mailing Address - Fax:
Practice Address - Street 1:2635 S.E. MILITARY DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223
Practice Address - Country:US
Practice Address - Phone:210-202-3022
Practice Address - Fax:210-337-3650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIALYSIS NEWCO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment