Provider Demographics
NPI:1851569511
Name:USRC ATASCOSA COUNTY DIALYSIS LLC
Entity Type:Organization
Organization Name:USRC ATASCOSA COUNTY DIALYSIS LLC
Other - Org Name:U.S. RENAL CARE ATASCOA COUNTY DIALYSIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VP, GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:PO BOX 19119
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72403-6601
Mailing Address - Country:US
Mailing Address - Phone:870-931-5400
Mailing Address - Fax:870-931-5418
Practice Address - Street 1:1320 W OAKLAWN RD G H
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-4315
Practice Address - Country:US
Practice Address - Phone:830-569-3052
Practice Address - Fax:830-569-3018
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US RENAL CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-15
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008674261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2118903-01Medicaid
TX2118903-01Medicaid