Provider Demographics
NPI:1366259962
Name:USRC FALL CREEK, LLC
Entity type:Organization
Organization Name:USRC FALL CREEK, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2730
Mailing Address - Street 1:9356 N SAM HOUSTON PKWY E STE 100
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4378
Mailing Address - Country:US
Mailing Address - Phone:281-201-1555
Mailing Address - Fax:281-201-4348
Practice Address - Street 1:9356 N SAM HOUSTON PKWY E STE 100
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4378
Practice Address - Country:US
Practice Address - Phone:281-201-1555
Practice Address - Fax:281-201-4348
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S. RENAL CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-17
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment