Healthcare Provider Details

I. General information

NPI: 1205759594
Provider Name (Legal Business Name): ADVANCED KIDNEY ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5011 HEATHER MEADOW LN
SUGAR LAND TX
77479-6801
US

IV. Provider business mailing address

5011 HEATHER MEADOW LN
SUGAR LAND TX
77479-6801
US

V. Phone/Fax

Practice location:
  • Phone: 123-456-7890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALI KHAN
Title or Position: OWNER
Credential: MD
Phone: 224-478-2327