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General NPI Number Information
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NPI Number | 1205224268
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Entity Type | Organization
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Legal Business Name | ADVANCED KIDNEY CARE PLLC
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 12/29/2014
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Provider Practice Location Address
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Address Line | 9716 SLIDE ST
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City | PLANO
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State | TX
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Zip | 75025-5862
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Country | US
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Telephone | 732-986-8643
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Fax |
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Provider Business Mailing Address
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Address Line | 9716 SLIDE ST
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City | PLANO
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State | TX
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Zip | 75025-5862
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Country | US
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Telephone | 732-986-8643
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANDEEP SINGH
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Credential | M.D
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Telephone | 732-986-8643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | Q0565
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License Number State | TX
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