Provider Demographics
NPI:1780743906
Name:NRA-PORT LAVACA, TEXAS, LLC
Entity type:Organization
Organization Name:NRA-PORT LAVACA, TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-771-4400
Mailing Address - Street 1:730 COOL SPRINGS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7289
Mailing Address - Country:US
Mailing Address - Phone:615-771-4400
Mailing Address - Fax:615-771-4401
Practice Address - Street 1:1300 N VIRGINIA ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PORT LAVACA
Practice Address - State:TX
Practice Address - Zip Code:77979-2509
Practice Address - Country:US
Practice Address - Phone:361-551-2566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPENDING261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment