Provider Demographics
NPI:1336195841
Name:USRC TARRANT L P
Entity Type:Organization
Organization Name:USRC TARRANT L P
Other - Org Name:USRC TARRANT DIALYSIS MANSFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position: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 952074
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75395-2074
Mailing Address - Country:US
Mailing Address - Phone:870-931-5400
Mailing Address - Fax:870-931-5418
Practice Address - Street 1:1800 HIGHWAY 157 N STE 101
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3930
Practice Address - Country:US
Practice Address - Phone:682-518-0126
Practice Address - Fax:682-518-0533
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:US RENAL CARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-26
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008464261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017939OtherKIDNEY HEALTH CARE
TX186431610Medicaid
TXHH045YOtherBLUE CROSS
TX023076OtherKIDNEY HEALTH CENTER (KHC)
TX186431611Medicaid
452896Medicare Oscar/Certification