NORTH TEXAS KIDNEY DISEASE ASSOCIATES NPI 1063871440

NPI Information

NPI: 1063871440
Provider Name: NORTH TEXAS KIDNEY DISEASE ASSOCIATES
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 45D1021344

Address:
4370 MEDICAL ARTS DR
SUITE 210
FLOWER MOUND, TX
ZIP 75028
Phone: (972) 219-0558
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NORTH TEXAS KIDNEY DISEASE ASSOCIATES is a nephrology internal medicine in Flower Mound, TX. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. NORTH TEXAS KIDNEY DISEASE ASSOCIATES NPI is 1063871440. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4370 MEDICAL ARTS DR
SUITE 210
FLOWER MOUND, TX
ZIP 75028
Phone: (972) 219-0558
Fax: (972) 436-9273

The provider's authorized official is Tammy Vaughn .
The authorized official title is Credentialing Coordinator and has the following contact phone number (940) 320-1708.

The CLIA number assigned to this NPI record is 45D1021344 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2016 and was last updated on 7/11/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	146883702	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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