ANGELO KIDNEY CONNECTION PLLC NPI 1952589665

NPI Information

NPI: 1952589665
Provider Name: ANGELO KIDNEY CONNECTION, PLLC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

CLIA Number: 45D1080496

Address:
2901 SHERWOOD WAY
SUITE 100
SAN ANGELO, TX
ZIP 76901
Phone: (326) 617-2496
Get Directions

ANGELO KIDNEY CONNECTION, PLLC is an end-stage renal disease (esrd) treatment clinic center in San Angelo, TX. ANGELO KIDNEY CONNECTION, PLLC NPI is 1952589665. The provider is registered as an organization entity type.

The provider's business location address is:

2901 SHERWOOD WAY
SUITE 100
SAN ANGELO, TX
ZIP 76901-586
Phone: (326) 617-2496
Fax: (325) 617-2497

The provider's authorized official is Melanie L. Baumgartner .
The authorized official title is Administrator/ceo and has the following contact phone number (325) 617-2496.

The CLIA number assigned to this NPI record is 45D1080496 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/5/2008 and was last updated on 9/10/2010.

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	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment			No
2	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	8643	TEXAS	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	672594	MEDICARE OSCAR/CERTIFICATION	TEXAS
2	1948945	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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »