USRC BLUEBONNET HOME LLC NPI 1609473941

NPI Information

NPI: 1609473941
Provider Name: USRC BLUEBONNET HOME, LLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 45D2198468

Address:
1902 WINDSOR PL STE 202
FORT WORTH, TX
ZIP 76110
Phone: (817) 953-5511
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USRC BLUEBONNET HOME, LLC is an end-stage renal disease (esrd) treatment clinic center in Fort Worth, TX. USRC BLUEBONNET HOME, LLC NPI is 1609473941. The provider is registered as an organization entity type.

The provider's business location address is:

1902 WINDSOR PL STE 202
FORT WORTH, TX
ZIP 76110-866
Phone: (817) 953-5511
Fax: (817) 953-3930

The provider's authorized official is Thomas L Weinberg .
The authorized official title is Chairman and has the following contact phone number (214) 736-2730.

The CLIA number assigned to this NPI record is 45D2198468 - end stage renal disease dialysis with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/8/2020 and was last updated on 10/8/2020.

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

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: 11/14/2023

NPI Synchronization or Removal

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