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SAKDC - DAVITA DIALYSIS PARTNERS LP NPI 1699969907


NPI Information

NPI: 1699969907
Provider Name: SAKDC - DAVITA DIALYSIS PARTNERS LP

Doing Business As: BOERNE DIALYSIS CENTER

Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 45D1075891

Address:
1369 S MAIN ST
STE 101
BOERNE, TX
ZIP 78006
Phone: (830) 249-1491
Get Directions

SAKDC - DAVITA DIALYSIS PARTNERS LP is an end-stage renal disease (esrd) treatment clinic center in Boerne, TX. SAKDC - DAVITA DIALYSIS PARTNERS LP NPI is 1699969907. The provider is registered as an organization entity type.
The provider Is Doing Business As Boerne Dialysis Center.

The provider's business location address is:

1369 S MAIN ST
STE 101
BOERNE, TX
ZIP 78006-860
Phone: (830) 249-1491
Fax: (830) 249-1508

The provider's authorized official is Samuel T Wey .
The authorized official title is Vp Licensure&certification and has the following contact phone number (615) 341-6641.

The CLIA number assigned to this NPI record is 45D1075891 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2007 and was last updated on 2/6/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11812232-06MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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