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General NPI Number Information
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NPI Number | 1750405197
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS KIDNEY DISEASE ASSOCIATES
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 07/17/2024
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Provider Practice Location Address
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Address Line | 3315 COLORADO BLVD STE 102
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City | DENTON
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State | TX
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Zip | 76210
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Country | US
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Telephone | 940-320-1708
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Fax | 940-565-5457
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Provider Business Mailing Address
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Address Line | 1600 WATERS RIDGE DR STE A
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City | LEWISVILLE
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State | TX
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Zip | 75057-6039
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Country | US
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Telephone | 972-219-0558
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Fax | 214-466-7237
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | SIRENA MARTIN
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Credential |
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Telephone | 144-667-2302
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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 |
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License Number State |
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