TYLER KIDNEY DOCTORS PA (NPI# 1023198637) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023198637 |
| Entity Type | Organization |
| Organization Name | TYLER KIDNEY DOCTORS PA |
| Practice Address |
700 Olympic Plaza Cir 912 Tyler TX 75701-1951 |
| Mailing Address |
Po Box 132506 Tyler TX 75713-2506 |
| Practice Telephone | 9035942293 |
| Practice Fax Number | 9038489513 |
| Mailing Telephone | 9035942293 |
| Mailing Fax Number | 9035660167 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2008-03-11 |
| Authorized Official Name | ROBERT C DOBROWOLSKI (PHYSICIAN) |
| Authorized Official Telephone | 9035942293 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
J8518 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS GROUP | 0032NC | 01 |
| Street Address |
700 OLYMPIC PLAZA CIR 912 |
| City | TYLER |
| State | TX |
| Zip Code | 75701-1951 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112933 | Robert M Sutherland | Anesthesiology | 700 Olympic Plaza Cir, Ste 404, Tyler, TX 75701-1955 | 2005-05-24 |
| 1043729429 | New Horizon Women's Healthcare, Pa | Obstetrics & Gynecology | 700 Olympic Plaza Cir, Suite 503, Tyler, TX 75701 | 2017-09-28 |
| 1942661756 | Olivia Lane Urben Snodgrass | Physician Assistant | 700 Olympic Plaza Cir, Suite 510, Tyler, TX 75701-1951 | 2016-03-08 |
| 1487024709 | Kristin Meharry | Registered Nurse | 700 Olympic Plaza Cir, Suite 600, Tyler, TX 75701-1951 | 2015-09-29 |
| 1760890693 | Neal Alton Burgess | Physician Assistant | 700 Olympic Plaza Cir, Suite 700, Tyler, TX 75701-1951 | 2014-07-23 |
| 1447517016 | Michelle Phi Medel | Obstetrics & Gynecology | 700 Olympic Plaza Cir, Ste 602, Tyler, TX 75701-1951 | 2012-04-19 |
| 1568733251 | Lester B Collins IIi Md PC | Psychiatry & Neurology | 700 Olympic Plaza Cir, Suite 910, Tyler, TX 75701-1951 | 2012-01-26 |
| 1639469281 | Moises A Sidransky | Anesthesiology | 700 Olympic Plaza Cir, Ste 850, Tyler, TX 75701-1951 | 2011-04-17 |
| 1699074351 | William Riddick Armstrong IIi | Urology | 700 Olympic Plaza Cir, Suite 700, Tyler, TX 75701-1951 | 2011-03-21 |
| 1467752915 | Jason Bradley Johnson | Nurse Practitioner | 700 Olympic Plaza Cir, Suite 600, Tyler, TX 75701-1951 | 2010-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962057059 | Gonzalo Fernandez | Physical Therapy Assistant | 753 S Beckham Ave, Tyler, TX 75701 | 2019-08-06 |
| 1215422654 | Adrianna Bussell | Nurse Practitioner | 1000 South Beckham, Tyler, TX 75701 | 2018-06-28 |
| 1285128017 | Idowu Akintokunbo Akinyele | Dentist | Aspen Dental, 4164 S Broadway Ave, Tyler, TX 75701 | 2018-06-15 |
| 1992208912 | Heather Renee Vancleave | Occupational Therapy Assistant | 1228 Louann Lane, Tyler, TX 75701 | 2018-03-15 |
| 1497260533 | Smile Workshop Mckinney, Pllc | Dentist | 301 N. Custer Rd, Mckinney, TX 75701 | 2017-12-12 |
| 1396266441 | Eye Surgery Center of East Texas, Pllc | Clinic/Center | 2448 E 5th St, Tyler, TX 75701 | 2017-06-29 |
| 1962936369 | Collins Complete Family Care | Nurse Practitioner | 1910 E Se Loop 323 # 176, Tyler, TX 75701 | 2017-04-12 |
| 1386187052 | Fellowship Health Team LLC | Home Health | 1124 S Fleishel Ave, Tyler, TX 75701 | 2016-11-29 |
| 1205382454 | Brenton Robinson | Nurse Practitioner | 1100 East Lake St, 160, Tyler, TX 75701 | 2016-08-28 |
| 1851846208 | Care First Pharmacy, LLC | Pharmacy | 1910 Roseland Blvd A, Tyler, TX 75701 | 2016-08-15 |
| Find all providers in zip 75701 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306125836 | Rudrick Villoso Ledesma | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2011-08-15 |
| 1689952509 | Madeline Jimenez-torres | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701 | 2011-07-26 |
| 1265721401 | Premier Nephrology of Tyler | Internal Medicine | 1304 Doctors Dr, Tyler, TX 75701-2262 | 2011-03-28 |
| 1003087388 | Ifeatu Uchenna Oti | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2008-03-14 |
| 1346433216 | Corey Ball | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2007-08-23 |
| 1972642965 | Aideloje A. Onime | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2007-02-06 |
| 1184773780 | Stephen D Pamatmat | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2007-01-10 |
| 1033268628 | Charles O Orji | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2007-01-10 |
| 1245389139 | Thomas Lowery | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2007-01-09 |
| 1841349875 | James R Cotton Jr. | Internal Medicine | 1133 Medical Dr, Tyler, TX 75701-2130 | 2007-01-09 |
| Find all providers in TYLER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.