Southlake Dialysis LLC
NPI #1568708279 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1568708279
- Entity Type
- Organization
- Organization Name
- Southlake Dialysis LLC
- Primary Specialty
- Clinic/Center - End-Stage Renal Disease (ESRD) Treatment
- Enumeration Date
- Dec 27, 2012
- Last Updated
- May 1, 2025
Practice Location
- Address
- 1710 N 9TH ST
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-8283
- Phone
- (918) 355-0657
Authorized Official
- Name
- SAMUEL WEY
- Title
- VP LICENSURE & CERTIFICATION
- Phone
- (615) 341-6641
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - End-Stage Renal Disease (ESRD) Treatment — End-Stage Renal Disease (ESRD) Treatment |
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