Organization · Type 2 NPI

Dva Renal Healthcare Inc

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

NPI number 1962466649 Active

Practice location

1724 Birmingham Rd, Ste 101
College Station, TX 77845-4063

Call (979) 704-6903 Map

Fax (979) 704-6906

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	110450 (TX)

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

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

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NPI record

NPI: 1962466649
Entity type: Organization (Type 2)
Issued: Apr 12, 2006
Last updated: Jun 8, 2026
Status: Active

Other names

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Rock Prairie Road Dialysis · doing business as
Rock Prairie Road Dialysis · doing business as

Authorized official

Samuel Wey
VP, Licensure & Certification
(615) 341-6641

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1962466649

Dva Renal Healthcare Inc's National Provider Identifier is 1962466649, issued on Apr 12, 2006. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in College Station, TX. The record was last updated on Jun 8, 2026.