Provider Demographics
NPI:1619032505
Name:UNITED RENAL CARE L.L.C.
Entity Type:Organization
Organization Name:UNITED RENAL CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:BENJAMIN
Authorized Official - Last Name:CARRALES
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:956-682-5578
Mailing Address - Street 1:1217 PECAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4349
Mailing Address - Country:US
Mailing Address - Phone:956-682-5578
Mailing Address - Fax:956-682-4653
Practice Address - Street 1:1217 PECAN BLVD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4349
Practice Address - Country:US
Practice Address - Phone:956-682-5578
Practice Address - Fax:956-682-4653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX581780302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization