DVA RENAL HEALTHCARE INC NPI 1306809454

NPI Information

NPI: 1306809454
Provider Name: DVA RENAL HEALTHCARE INC
Classification: Clinic/Center - 261QE0700X
Specialization: End-Stage Renal Disease (ESRD) Treatment
Entity Type: Organization
Doing Business As: BRIARCREST DIALYSIS
CLIA Number: 45D0702391
Address: 1640 BRIARCREST DR STE 100
BRYAN, TX
ZIP 77802
Phone: (979) 260-4908

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NPI Details

DVA RENAL HEALTHCARE INC is an end-stage renal disease (esrd) treatment clinic center in Bryan, TX. DVA RENAL HEALTHCARE INC NPI is 1306809454. The provider is registered as an organization entity type.
The provider Is Doing Business As Briarcrest Dialysis.

The provider's business location address is:

1640 BRIARCREST DR STE 100
BRYAN, TX
ZIP 77802-933
Phone: (979) 260-4908
Fax: (979) 268-5890

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 45D0702391 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/10/2006 and was last updated on 12/19/2024.

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
1	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			Yes

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
1	094256701	MEDICAID	TEXAS
2	953372911125	OTHER		TRICARE

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: 11/21/2025

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