Provider Demographics
NPI:1740578822
Name:DENTON LD LLC
Entity Type:Organization
Organization Name:DENTON LD LLC
Other - Org Name:LIBERTY DIALYSIS - LAKE LEWISVILLE
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 1:3400 CORINTH PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76208-1313
Mailing Address - Country:US
Mailing Address - Phone:940-497-1414
Mailing Address - Fax:940-497-2774
Practice Address - Street 1:3400 CORINTH PKWY STE 130
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76208-1313
Practice Address - Country:US
Practice Address - Phone:940-497-1414
Practice Address - Fax:940-497-2774
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESENIUS MEDICAL CARE HOLDINGS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-11
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment