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General NPI Number Information
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NPI Number | 1881067973
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Entity Type | Organization
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Legal Business Name | MIDLAND KIDNEY CARE PLLC
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Dates
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Enumeration Date | 11/11/2015
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 3302 W GOLF COURSE RD STE 100
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City | MIDLAND
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State | TX
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Zip | 79703-5110
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Country | US
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Telephone | 432-522-2304
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Fax | 432-522-2307
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Provider Business Mailing Address
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Address Line | 3302 W GOLF COURSE RD STE 100
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City | MIDLAND
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State | TX
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Zip | 79703-5110
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Country | US
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Telephone | 432-522-2304
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Fax | 432-522-2307
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Authorized Official
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Title or Position | PRESIDENT
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Name | RYAN VALLE
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Credential |
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Telephone | 781-699-9362
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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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