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NPI Code Detail

MEDICARE: DALLAS NEPHROLOGY ASSOCIATES

MEDICARE: DALLAS NEPHROLOGY ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1130377OTHERTXASC

General Provider Information

NPI Number : 1053634030
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLAS NEPHROLOGY ASSOCIATES
Provider Business Mailing Address
First Line : 1505 LBJ FWY STE 700
Second Line :
City : DALLAS
State : TX
Zip : 75234-6065
Country : US
Telephone Number : 214-358-2300
Fax Number : 214-579-6941
Provider Business Practice Location Address
First Line : 3604 LIVE OAK ST
Second Line : SUITE 300
City : DALLAS
State : TX
Zip : 75204-6168
Country : US
Telephone Number : 214-826-4224
Fax Number : 214-826-6442
Authorized Official
Title or Position : PRESIDENT/CEO
Name : ALEXANDER LIANG
Credential : MD
Telephone Number : 214-358-2300
Provider Enumeration Date : 03/05/2010
Last Update Date : 03/17/2026

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1174636401 — CAROLYN COLETTE COCHRAN RD,LD,MS,CDE
Practice Location Address:
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Practice Phone: 214-358-2300
Practice Fax: 214-366-6330

Directions to “DALLAS NEPHROLOGY ASSOCIATES ” Practice Location

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