NPI age
10 years
Enumerated 2016-04-21
● Active Type 2 · Organization
Bannack Dialysis Llc
Bannack Dialysis Llc is 1 of 1165 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Wey
Vp Licensure & Certification
Last NPPES update
2024-07-17
Source: monthly bulk 2026-05
How this organization compares
Across 1165 active clinic/center providers in Texas.
NPI age
10 years
↓ 5 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2016 → 2026
2016-04Enumerated in NPPES
2016
2026
Where they practice
Primary practice location
12606 Westpark Dr
Houston, TX 770825526
Mailing address
5200 Virginia Way, L&c Dept
Brentwood, TN 370277569
Authorized official
Samuel T Wey
Vp Licensure & Certification
📞 6153416641
Individual providers at this organization
2 individual providers on file at this primary practice address.
- John Fangtang, PHARM.D.; DRPH Pharmacist NPI 1700114766
- Fatemeh Khajehei, PHARM-D Pharmacist NPI 1649508557
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 3746448-02 |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Dairy Ashford Dialysis
-
Dairy Ashford Dialysis
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.