Provider Demographics
NPI:1528406949
Name:FRESENIUS MEDICAL CARE SAN ANTONIO, LLC
Entity Type:Organization
Organization Name:FRESENIUS MEDICAL CARE SAN ANTONIO, LLC
Other - Org Name:FRESENIUS MEDICAL CARE WEST SEGUIN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BLANTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-699-9000
Mailing Address - Street 1:757 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5414
Mailing Address - Country:US
Mailing Address - Phone:830-379-1801
Mailing Address - Fax:830-303-9661
Practice Address - Street 1:757 W COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5414
Practice Address - Country:US
Practice Address - Phone:830-379-1801
Practice Address - Fax:830-303-9661
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-07
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX672616Medicare Oscar/Certification