DESOTO REGIONAL DIALYSIS CENTER LLC (NPI# 1003227075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003227075 |
| Entity Type | Organization |
| Organization Name | DESOTO REGIONAL DIALYSIS CENTER LLC |
| Practice Address |
2651 Bolton Boone Dr Building B Desoto TX 75115-2011 |
| Practice Telephone | 9727805991 |
| Practice Fax Number | 9727805992 |
| Mailing Telephone | 9727805991 |
| Mailing Fax Number | 9727805992 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | SHARI K COUSINS (SR. VP OF CLINICAL & REGULATORY) |
| Authorized Official Telephone | 9789223080 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 364692901 | 05 |
| Street Address |
2651 BOLTON BOONE DR BUILDING B |
| City | DESOTO |
| State | TX |
| Zip Code | 75115-2011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366413098 | Kyle Smith | Internal Medicine | 2651 Bolton Boone Dr, Desoto, TX 75115-2011 | 2006-01-31 |
| 1568725349 | Elizabeth A Garvey | Dietitian, Registered | 2651 Bolton Boone Dr, Desoto, TX 75115 | 2012-06-18 |
| 1376796656 | Hassan Alhalabi | Internal Medicine | 2651 Bolton Boone Dr, Desoto, TX 75115-2011 | 2008-10-30 |
| 1588816318 | Mario Javier Robles Franceschini | Internal Medicine | 2651 Bolton Boone Dr, Desoto, TX 75115-2011 | 2008-10-10 |
| 1972777852 | Venkata Yalamanchili | Internal Medicine | 2651 Bolton Boone Dr, Desoto, TX 75115-2011 | 2008-04-22 |
| 1548307820 | Richard Fuquay | Internal Medicine | 2651 Bolton Boone Dr, Desoto, TX 75115-2011 | 2007-01-30 |
| 1629170428 | Jamshid Amanzadeh | Internal Medicine | 2651 Bolton Boone Dr, Desoto, TX 75115-2011 | 2006-09-02 |
| 1427163286 | Najam M Firoz | Internal Medicine | 2651 Bolton Boone Dr, Desoto, TX 75115-2011 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860257 | Emeka Abazie Dds Pa | Dentist | 1001 N. Beckley, Suite 304, Desoto, TX 75115 | 2020-10-30 |
| 1407453384 | Heather Mcdowell | Massage Therapist | 100 Bob White St # 3, Desoto, TX 75115 | 2020-10-05 |
| 1295201580 | Daniel Max & Marcandrea, LLC | Optometrist | 1309 E. Pleasant Run Rd, Desoto, TX 75115 | 2018-10-15 |
| 1316432180 | Texas Home Health Group of De Soto, LLC | Home Health | 911 York Drive, Suite 203, De Soto, TX 75115 | 2018-06-25 |
| 1033606694 | Dental Health Associates of Texas, PC | Dentist | 1001 N Beckley, Desoto, TX 75115 | 2018-04-19 |
| 1023516093 | Joseph Chinaecherem Anya | Pharmacist | 805 Raintree Ln, Desoto, TX 75115 | 2018-01-25 |
| 1396253837 | Medical Care Innovation, P.C. | Clinic/Center | 2019 N Interstate 35 E, Desoto, TX 75115 | 2018-01-18 |
| 1124534888 | Herlonda Dotson | Counselor | 620 Candelila Drive, Desoto, TX 75115 | 2017-12-18 |
| 1053839548 | Floristene Johnson | Nutritionist | 1353 Armstrong Drive, Desoto, TX 75115 | 2017-09-05 |
| 1699290577 | Dlb Pharmacy LLC | Pharmacy | 1801 N Hampton, Suite 340, Desoto, TX 75115 | 2017-08-11 |
| Find all providers in zip 75115 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972524163 | Bio Medical Applications of Texas | Clinic/Center | 900 N Polk St Ste 146, Desoto, TX 75115-4017 | 2006-07-22 |
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| 1477165462 | Fresenius Medical Care South Lewisville, LLC | Clinic/Center | 101 E Southwest Pkwy Ste 110, Lewisville, TX 75067-8753 | 2020-08-20 |
| 1598383259 | Dialysis Clinic Inc. | Clinic/Center | 6146 Wurzbach Road, San Antonio, TX 78238 | 2020-07-09 |
| 1891312559 | Usrc Houston Newco Home LLC | Clinic/Center | 2000 Crawford St Ste 777, Houston, TX 77002-9006 | 2020-06-29 |
| 1427671502 | Usrc Plano Dexter, LLC | Clinic/Center | 4708 Dexter Dr, Plano, TX 75093-5288 | 2020-05-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.