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General NPI Number Information
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NPI Number | 1598172223
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Entity Type | Organization
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Legal Business Name | VICTORY KIDNEY CLINIC P.A.
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 1710 E SAUNDERS ST STE B280
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City | LAREDO
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State | TX
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Zip | 78041-5464
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Country | US
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Telephone | 956-718-1908
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Fax | 956-718-1928
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Provider Business Mailing Address
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Address Line | 1710 E SAUNDERS ST STE B280
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City | LAREDO
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State | TX
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Zip | 78041-5464
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Country | US
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Telephone | 956-718-1908
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Fax | 956-718-1928
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Authorized Official
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Title or Position | PRESIDENT
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Name | BICHENG NAN
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Credential | M.D.
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Telephone | 956-718-1908
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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 | N1011
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License Number State | TX
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