Organization · Type 2 NPI

Ponderosa Dialysis LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Dickinson, TX

NPI number 1275876633 Active

Practice location

3290 Gulf Fwy S Ste H
Dickinson, TX 77539-4542

Call (281) 337-2175 Map

Fax (281) 337-2386

Mailing address

5200 Virginia Way, L&c Dept
Brentwood, TN 37027-7569

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

Other end-stage renal disease (esrd) treatment clinic/center providers in Dickinson

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NPI record

NPI: 1275876633
Entity type: Organization (Type 2)
Issued: Apr 3, 2013
Last updated: Jul 7, 2026
Status: Active

Other names

<unavail>
Victory Lakes Dialysis · doing business as
Victory Lakes Dialysis · doing business as

Authorized official

Samuel T Wey
VP Licensure&certification
(615) 341-6641

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About NPI 1275876633

Ponderosa Dialysis LLC's National Provider Identifier is 1275876633, issued on Apr 3, 2013. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Dickinson, TX. The record was last updated on Jul 7, 2026.