SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C. (NPI# 1174710040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174710040 |
| Entity Type | Organization |
| Organization Name | SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C. |
| Practice Address |
1410 E Walnut St Seguin TX 78155-5175 |
| Mailing Address |
7142 San Pedro Ave Suite 120 San Antonio TX 78216-6256 |
| Practice Telephone | 8305495022 |
| Practice Fax Number | 8304334460 |
| Mailing Telephone | 2104817453 |
| Mailing Fax Number | 2104817463 |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2014-08-08 |
| Authorized Official Name | MR. CLAY ROBY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2106615622 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992002547 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 9846 Westover Hills Blvd, Suite 101, San Antonio, TX 78251-4125 | 2011-02-17 |
| 1114235934 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 1320 W Oaklawn Rd, Suite H, Pleasanton, TX 78064-4315 | 2010-09-14 |
| 1215057534 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 7114 San Pedro Ave, San Antonio, TX 78216-6218 | 2007-03-30 |
| 1114045846 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 32665 Hwy 281 N, Ste 206, Bulverde, TX 78163-3124 | 2007-03-27 |
| 1164540134 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 222 Sidney Baker S, Suite 208, Kerrville, TX 78028-5994 | 2007-03-27 |
| 1356325922 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 7142 San Pedro Ave, Ste 120, San Antonio, TX 78216-6256 | 2005-12-06 |
| 1417594995 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Clinic/Center | 7114 San Pedro Ave, San Antonio, TX 78216-6218 | 2019-12-04 |
| 1013336791 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Internal Medicine | 215 E Quincy St, Suite 420, San Antonio, TX 78215-2034 | 2014-04-10 |
| 1467707240 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 2902 Goliad Rd, Suite 103, San Antonio, TX 78223-3971 | 2012-07-18 |
| 1619274271 | San Antonio Kidney Disease Center Physicians Group, P.l.l.c. | Nurse Practitioner | 4653 Binz Engleman Rd, Suite 1, San Antonio, TX 78219-1712 | 2011-02-17 |
| Street Address |
1410 E WALNUT ST |
| City | SEGUIN |
| State | TX |
| Zip Code | 78155-5175 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417506098 | Brian Christianson | Specialist/Technologist | 1000 W. Court St, Athletic Training Clinic, Seguin, TX 78155 | 2019-09-06 |
| 1164903035 | Danie Marie Clifton | Licensed Vocational Nurse | 1265 Rawhide Rd, Seguin, TX 78155 | 2018-08-28 |
| 1871010959 | Lora Marie Varela | Occupational Therapy Assistant | 562 South Highway 123 Bypass, 224, Seguin, TX 78155 | 2017-08-29 |
| 1295251924 | Anas Hakimeh | Dentist | 901 N Hwy 123 Bypass, Seguin, TX 78155 | 2017-08-15 |
| 1225560774 | Amanda Shoemaker | Student in an Organized Health Care Education/Training Program | 1000 W. Court St., Seguin, TX 78155 | 2017-04-03 |
| 1952784670 | Evelyne Merab Matunda | Nurse Practitioner | 1350 Ashby St, Seguin, TX 78155 | 2015-06-30 |
| 1558798520 | Sound Asleep Dme | Durable Medical Equipment & Medical Supplies | 519 N. King St, Ste. 104, Seguin, TX 78155 | 2013-10-04 |
| 1154673101 | Lara A Perry Dds Pa | Dentist | 317 S Texas 46, Seguin, TX 78155 | 2012-10-15 |
| 1013222488 | Remarkable Healthcare of Seguin, Lp | Skilled Nursing Facility | 1339 Eastwood Drive, Seguin, TX 78155 | 2010-08-10 |
| 1750695342 | Ritchie Limb & Brace, LLC | Prosthetic/Orthotic Supplier | 1069 E. Gonzales, Seguin, TX 78155 | 2010-08-06 |
| Find all providers in zip 78155 | ||||
| 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 |
|---|---|---|---|---|
| 1043424286 | Shadi Mourad | Internal Medicine | 711 E Court St, Seguin, TX 78155-5719 | 2007-05-09 |
| 1467463893 | Charles Raymond Nolan IIi | Internal Medicine | 1215 East Court Street, Guadalupe Regional Medical Center, Seguin, TX 78155 | 2006-08-10 |
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|---|---|---|---|---|
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| 1962040949 | Ngoc-han Thi Tran | Internal Medicine | 3295 S Cooper St Ste 119, Arlington, TX 76015-2359 | 2019-12-20 |
| 1659916617 | Heartland Physicians Associates Nephrology Pllc | Internal Medicine | 150 Pine Forest Dr Ste 501, Shenandoah, TX 77384-5304 | 2019-11-14 |
| 1578106894 | Cardiorenal Therapeutics of North Texas Pllc | Internal Medicine | 300 N Highland Ave Ste 365, Sherman, TX 75092-7393 | 2019-10-18 |
| 1639711534 | Immaculate Vascular Access Center Pllc | Internal Medicine | 349 S Helen Moore Rd Apt 6205, San Benito, TX 78586-9091 | 2019-10-11 |
| 1376193433 | Ntkc - Dfw, Pllc | Internal Medicine | 10700 Victoria Ash Dr., Keller, TX 76244 | 2019-09-19 |
| 1841849098 | Austin Kidney Care LLC | Internal Medicine | 2005 Palo Duro Rd, Austin, TX 78757-3242 | 2019-09-10 |
| 1467000828 | Ntkc-dfw, Pllc | Internal Medicine | 2220 Bryan Pl Ste 104, Midlothian, TX 76065-7127 | 2019-08-29 |
| 1306407697 | H&n Medical Investment, LLC | Internal Medicine | 4201 Medical Center Dr. Ste 240, Mckinney, TX 75069-1774 | 2019-06-26 |
| Find all providers with the same taxonomy | ||||
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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.