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1033658174 NPI number — KIDNEY CARE OF DALLAS PLLC

NPI Number: 1033658174
Health Care Provider/Practitioner: KIDNEY CARE OF DALLAS PLLC

Information about “1033658174” NPI (KIDNEY CARE OF DALLAS PLLC) exists in 1033658174 in HTML format HTML  |  1033658174 in plain Text format TXT  |  1033658174 in PDF (Portable Document Format) PDF  |  1033658174 in an XML format XML  formats.

NPI Number : 1033658174 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1033658174",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KIDNEY CARE OF DALLAS PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "519 E INTERSTATE 30 STE 417",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ROCKWALL",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75087-5408",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "469-904-2020",
    "MailingAddressFaxNumber": "469-904-2028",
    "FirstLinePracticeLocationAddress": "10611 GARLAND RD STE 105",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75218-2680",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "469-904-2020",
    "PracticeLocationAddressFaxNumber": "469-904-2028",
    "EnumerationDate": "02/22/2017",
    "LastUpdateDate": "08/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ALI",
    "AuthorizedOfficialFirstName": "SYED",
    "AuthorizedOfficialMiddleName": "M",
    "AuthorizedOfficialTitle": "OWNER/MD",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "713-397-7789",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "P2822",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RN0300X",
          "TaxonomyName": "Nephrology Physician",
          "LicenseNumber": "P2822",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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