| NPI | 1255061164 |
|---|---|
| Doing Business As | NORTHEAST FORT WORTH DIALYSIS CENTER |
| Entity Type | Organization |
| Authorized Contact | BARRY L BLANTON VP 781-688-9000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2024-11-25 |