NORTH TEXAS KIDNEY DISEASE ASSOCIATES (NPI# 1790239911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790239911 |
| Entity Type | Organization |
| Organization Name | NORTH TEXAS KIDNEY DISEASE ASSOCIATES |
| Practice Address |
6190 Lbj Fwy Suite 702 Dallas TX 75240 |
| Mailing Address |
3315 Colorado Blvd Suite 102 Denton TX 76210-6884 |
| Practice Telephone | 2144667230 |
| Practice Fax Number | 2144667236 |
| Mailing Telephone | 9403201708 |
| Mailing Fax Number | 9405655457 |
| Enumeration Date | 2016-08-04 |
| Last Update Date | 2018-07-11 |
| Authorized Official Name | TAMMY VAUGHN (CREDENTAILING COORDINATOR) |
| Authorized Official Telephone | 9403201708 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTH TEXAS KIDNEY DISEASE ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 146883702 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154875839 | North Texas Kidney Disease Associates | Internal Medicine | 4708 Alliance Blvd Ste 685, Plano, TX 75093 | 2016-08-10 |
| 1750405197 | North Texas Kidney Disease Associates | Internal Medicine | 3315 Colorado Blvd Ste 102, Denton, TX 76210 | 2007-03-19 |
| 1821169632 | North Texas Kidney Disease Associates | Internal Medicine | 1600 Waters Ridge Dr, Ste. A, Lewisville, TX 75057 | 2006-11-13 |
| 1154777068 | North Texas Kidney Disease Associates | Internal Medicine | 4333 N Josey Ln, Suite 202, Carrollton, TX 75010 | 2016-05-10 |
| 1770942773 | North Texas Kidney Disease Associates | Internal Medicine | 4312 Heritage Trace Pkwy, Suite 708, Fort Worth, TX 76244 | 2016-02-18 |
| 1063871440 | North Texas Kidney Disease Associates | Internal Medicine | 4370 Medical Arts Dr, Suite 210, Flower Mound, TX 75028 | 2016-02-15 |
| 1174990311 | North Texas Kidney Disease Associates | Internal Medicine | 4401 Coit Rd, Suite 303, Frisco, TX 75035 | 2015-08-24 |
| 1093182305 | North Texas Kidney Disease Associates | Internal Medicine | 2609 Scripture St, Denton, TX 76201 | 2015-08-24 |
| 1285036756 | North Texas Kidney Disease Associates | Internal Medicine | 1600 Coit Rd, Bldg. 1, Suite 300, Plano, TX 75075 | 2014-09-16 |
| 1245492511 | North Texas Kidney Disease Associates | Internal Medicine | 6331 Boulevard 26, Ste. 220, North Richland Hills, TX 76180 | 2008-06-27 |
| Street Address |
6190 LBJ FWY SUITE 702 |
| City | DALLAS |
| State | TX |
| Zip Code | 75240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659425262 | John A Grinaldi | Dentist | 6190 Lbj Fwy, Suite 900, Dallas, TX 75240-6344 | 2007-01-22 |
| 1790932978 | Nivin Aziz | Internal Medicine | 6190 Lbj Fwy, 702, Dallas, TX 75240-6344 | 2008-08-19 |
| 1972778678 | David Brehm, Md, Pa | Family Medicine | 6190 Lbj Fwy, Suite 800, Dallas, TX 75240 | 2008-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104469824 | Amber Christine Wrye | Counselor | 5433 Alpha Rd, Dallas, TX 75240 | 2019-10-25 |
| 1134610934 | Kristen Cairns | Counselor | 13140 Coit Rd # 328, Dallas, TX 75240 | 2018-05-29 |
| 1255821435 | Axiom Health Services, LLC | Specialist/Technologist, Other | 5422 Alpha Rd, Dallas, TX 75240 | 2018-05-14 |
| 1114438991 | Donald R Missel | Nurse Anesthetist, Certified Registered | 6606 Lbj Freeway, Suite 200, Dallas, TX 75240 | 2017-10-19 |
| 1689119307 | Ginger Lee Hagood | Counselor | 5580 Lbj Freeway, Suite 300, Dallas, TX 75240 | 2017-01-04 |
| 1831565712 | Stella I Clark | Nurse's Aide | 7373 Valley View Ln #2065, Dallas, TX 75240 | 2015-08-14 |
| 1790163608 | Shana Lynn Gangi | Social Worker | 13601 Preston Rd Ste W970, Dallas, TX 75240 | 2015-05-12 |
| 1134527096 | Jahvel Thompson | Physician Assistant | 8112 W. Spring Valley Rd., Dallas, TX 75240 | 2014-12-09 |
| 1295137396 | Rineil Francis Perez | Pharmacist | 13131 Monfort Dr, Dallas, TX 75240 | 2014-09-19 |
| 1255731311 | Arturo Ojeda | Counselor | 13140 Coit Rd Ste 326, Dallas, TX 75240 | 2014-08-26 |
| Find all providers in zip 75240 | ||||
| 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 |
|---|---|---|---|---|
| 1013424860 | Farahat and Associates Pllc | Internal Medicine | 7475 La Vista Dr Apt 1834, Dallas, TX 75214-4132 | 2018-01-02 |
| 1205199619 | Muthanna Mohammad Saraireh | Internal Medicine | 3600 Gaston Ave Ste 904, Dallas, TX 75246-1809 | 2012-06-20 |
| 1053686121 | Lucile Parker Gregg | Internal Medicine | Ut Southwestern Medical Center Nephrology, 5323 Harry Hines Blvd, Dallas, TX 75390-8516 | 2012-03-21 |
| 1164791398 | Kidney and Hypertension Associates of Dallas Pllc | Internal Medicine | 3900 Junius St Ste 615, Dallas, TX 75246-1615 | 2011-12-16 |
| 1548573587 | Mamatha Racheruvu | Internal Medicine | 3571 W Wheatland Rd # 101, Dallas, TX 75237-3461 | 2010-07-20 |
| 1689994956 | Paul Cespedes | Internal Medicine | 7777 Forest Ln Ste C865, Dallas, TX 75230 | 2010-06-09 |
| 1447492756 | Ntkc Management, LLC | Internal Medicine | 3900 Junius Street, Suite 615, Dallas, TX 75246 | 2009-04-01 |
| 1407055155 | Ala'a Farahat | Internal Medicine | 3822 Brown St, Dallas, TX 75219-4014 | 2007-07-13 |
| 1295856003 | Kamalanthan Kolandavelu Sambandam | Internal Medicine | 5939 Harry Hines Suite 700, Dallas, TX 75390 | 2007-04-02 |
| 1033268354 | Soon Chao S Ong | Internal Medicine | 5050 Quorum Dr Ste 700, Dallas, TX 75254-1410 | 2007-01-09 |
| Find all providers in DALLAS | ||||
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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.