Provider Demographics
NPI:1518306695
Name:ACCESSCARE TEXAS DIALYSIS
Entity Type:Organization
Organization Name:ACCESSCARE TEXAS DIALYSIS
Other - Org Name:ACCESSCARE OF NORTH TEXAS DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HEDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-328-6919
Mailing Address - Street 1:3118 LOS COLINAS
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-3422
Mailing Address - Country:US
Mailing Address - Phone:940-387-1474
Mailing Address - Fax:512-328-0779
Practice Address - Street 1:3118 LOS COLINAS
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-3422
Practice Address - Country:US
Practice Address - Phone:940-387-1474
Practice Address - Fax:512-328-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment