Healthcare Provider Details

I. General information

NPI: 1265477152
Provider Name (Legal Business Name): KIDNEY CARE ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 07/05/2023
Certification Date: 07/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E TAYLOR ST STE 103
SHERMAN TX
75090-2810
US

IV. Provider business mailing address

600 E TAYLOR ST STE 103
SHERMAN TX
75090-2810
US

V. Phone/Fax

Practice location:
  • Phone: 903-893-7170
  • Fax: 903-893-4372
Mailing address:
  • Phone: 903-893-7170
  • Fax: 903-893-4372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberG0858
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberG0858
License Number StateTX

VIII. Authorized Official

Name: DR. WIRASAT HASNAIN
Title or Position: PARTNER
Credential: MD
Phone: 903-893-7170