RAYBURN DIALYSIS LLC (NPI# 1053689034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053689034 |
| Entity Type | Organization |
| Organization Name | RAYBURN DIALYSIS LLC |
| Other Organization Name | ODESSA DIALYSIS |
| Practice Address |
6005 Eastridge Rd Odessa TX 79762-5019 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 4323623008 |
| Practice Fax Number | 4323623302 |
| Mailing Telephone | 6153204550 |
| Mailing Fax Number | 8665008578 |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2012-12-21 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2533821919 |
| 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 |
110111 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | KIDNEY PROGRAM | 027740 | 01 |
| TX | 297639101 | 05 |
| Other Name | Type Code |
|---|---|
| Odessa Dialysis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790053775 | Rayburn Dialysis LLC | Clinic/Center | 705 W Wadley Ave, Midland, TX 79705-5351 | 2011-12-06 |
| Street Address |
6005 EASTRIDGE RD |
| City | ODESSA |
| State | TX |
| Zip Code | 79762-5019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306820451 | Douglas Park I, Ltd | Clinic/Center | 6005 Eastridge Rd, Odessa, TX 79762-5019 | 2005-12-02 |
| 1396183141 | Hochatown Dialysis LLC | Clinic/Center | 6005 Eastridge Rd, Odessa, TX 79762-5019 | 2013-06-13 |
| 1275892499 | Kamal N. Tolia, M.d., P.a. | Obstetrics & Gynecology | 6005 Eastridge Rd, Suite 110, Odessa, TX 79762-5019 | 2012-05-08 |
| 1700159738 | Nalin H Tolia Pa | Ophthalmology | 6005 Eastridge Rd, Suite 100, Odessa, TX 79762-5019 | 2012-02-22 |
| 1023193141 | Kamal Nalin Tolia | Obstetrics & Gynecology | 6005 Eastridge Rd, Suite 110, Odessa, TX 79762-5019 | 2006-10-26 |
| 1184709388 | Nalin Harilal Tolia | Ophthalmology | 6005 Eastridge Rd, Suite 100, Odessa, TX 79762-5019 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982256798 | Winwood Dental and Orthodontics Pllc | Dentist | 3913 E 42nd Street, Odessa, TX 79762 | 2019-07-11 |
| 1265995716 | Ryan Daniels | Specialist/Technologist | 4901 E University, Gym 111, Odessa, TX 79762 | 2019-04-11 |
| 1215429592 | Michael Wayne Samp | Respiratory Therapist, Registered | 2807 Windsor Dr, Odessa, TX 79762 | 2018-06-03 |
| 1972003663 | Kristi Young | Registered Nurse | 3800 E. 42nd St., Suite 203 Attn: Pediatric Dept, Odessa, TX 79762 | 2018-02-19 |
| 1427508902 | Whitney Diakur | Optometrist | 5011 E. 42nd St, Odessa, TX 79762 | 2016-10-10 |
| 1295184927 | Farqad Kamal Abuoudeh | Dentist | 6109 Tx-191 Frontage, Odessa, TX 79762 | 2016-06-03 |
| 1457714180 | Daniel & Max, LLC | Optometrist | 5011 E. 42nd Street, Odessa, TX 79762 | 2016-03-31 |
| 1407225774 | Neri Campos-gardea | Massage Therapist | 3952 E 42d, Odessa, TX 79762 | 2015-09-17 |
| 1508255886 | Permian Er IIi | Clinic/Center | 6131 East Highway 191, Odessa, TX 79762 | 2015-01-09 |
| 1548675861 | Tina Desai | Dentist | 6109 Texas 191, Odessa, TX 79762 | 2014-06-25 |
| Find all providers in zip 79762 | ||||
| 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 |
|---|---|---|---|---|
| 1457721292 | Winster Dialysis LLC | Clinic/Center | 800 N Texas Ave, Odessa, TX 79761-4012 | 2015-10-06 |
| 1639597552 | Complete Dialysis Care LLC | Clinic/Center | 607 East 7th Street, Odessa, TX 79761-4509 | 2014-03-29 |
| 1407001613 | Permian Nephrology Associates Pa | Clinic/Center | 230 N Washington Ave, Odessa, TX 79761-5424 | 2008-12-02 |
| 1467564351 | Bio-medical Applications of Texas, Inc. | Clinic/Center | 1501 E 8th St, Odessa, TX 79761-4804 | 2006-08-31 |
| 1952413007 | Renal Center of Midland-odessa, Lp, Lllp | Clinic/Center | 4241 Tanglewood, Suite 104, Odessa, TX 79762-5988 | 2006-08-31 |
| 1306820451 | Douglas Park I, Ltd | Clinic/Center | 6005 Eastridge Rd, Odessa, TX 79762-5019 | 2005-12-02 |
| 1396183141 | Hochatown Dialysis LLC | Clinic/Center | 6005 Eastridge Rd, Odessa, TX 79762-5019 | 2013-06-13 |
| 1871884163 | Bio-medical Applications of Texas, Inc. | Clinic/Center | 230 N Washington Ave, Odessa, TX 79761-5424 | 2011-04-21 |
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| 1003422171 | Usrc Dialysis At Home West LLC | Clinic/Center | 12011 State Highway 151 Ste 222, San Antonio, TX 78251-1230 | 2020-09-23 |
| 1477165462 | Fresenius Medical Care South Lewisville, LLC | Clinic/Center | 101 E Southwest Pkwy Ste 110, Lewisville, TX 75067-8753 | 2020-08-20 |
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| 1891312559 | Usrc Houston Newco Home LLC | Clinic/Center | 2000 Crawford St Ste 777, Houston, TX 77002-9006 | 2020-06-29 |
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| Find all providers with the same taxonomy | ||||
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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.