Basic Information
| Provider Information | |||||||||
| NPI: | 1801402979 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | USRC GARLAND LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 251549 | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750251500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2147362700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 219 W KINGSLEY RD STE 316 | ||||||||
| Address2: | |||||||||
| City: | GARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750413434 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4699040007 | ||||||||
| FaxNumber: | 4699040480 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2020 | ||||||||
| LastUpdateDate: | 09/23/2020 | ||||||||
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| AuthorizedOfficialLastName: | WEINBERG | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | CHAIRMAN | ||||||||
| AuthorizedOfficialTelephone: | 2147362730 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | US RENAL CARE INC. | ||||||||
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| NPICertificationDate: | 09/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0700X | Y | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment |
No ID Information.