NTKC-DFW, PLLC (NPI# 1902131261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902131261 |
| Entity Type | Organization |
| Organization Name | NTKC-DFW, PLLC |
| Other Organization Name | NORTH TEXAS KIDNEY CONSULTANTS |
| Practice Address |
3801 William D Tate Ave Ste 105 Grapevine TX 76051-8755 |
| Practice Telephone | 8174886812 |
| Practice Fax Number | 8172511303 |
| Mailing Telephone | 8174886812 |
| Mailing Fax Number | 8172511303 |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2019-06-27 |
| Authorized Official Name | DAN N BACCUS (CFO) |
| Authorized Official Telephone | 8174886669 |
| Is Organization Subpart | N |
| 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 | 209283502 | 05 |
| Other Name | Type Code |
|---|---|
| North Texas Kidney Consultants | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467000828 | Ntkc-dfw, Pllc | Internal Medicine | 2220 Bryan Pl Ste 104, Midlothian, TX 76065-7127 | 2019-08-29 |
| 1386979649 | Ntkc-dfw, Pllc | Internal Medicine | 2425 Highway 121 Ste 201, Bedford, TX 76021-5011 | 2009-10-05 |
| 1427450345 | Ntkc-dfw, Pllc | Internal Medicine | 1200 Crawford Ave, Suite E, Granbury, TX 76048-4561 | 2014-09-23 |
| 1124459813 | Ntkc-dfw, Pllc | Internal Medicine | 1200 Crawford Ave, Suite E, Granbury, TX 76048-4561 | 2013-12-05 |
| 1598090854 | Ntkc-dfw, Pllc | Internal Medicine | 4907 S Collins St, Suite 101, Arlington, TX 76018-1156 | 2009-10-05 |
| 1366777625 | Ntkc-dfw, Pllc | Internal Medicine | 805 Hill Blvd, Suite 102, Granbury, TX 76048-1481 | 2009-10-05 |
| Street Address |
3801 WILLIAM D TATE AVE STE 105 |
| City | GRAPEVINE |
| State | TX |
| Zip Code | 76051-8755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619411618 | Fei Xie | Nurse Practitioner | 3801 William D Tate Ave Ste 105, Grapevine, TX 76051-8755 | 2016-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881227346 | Jeffrey Joseph Cervenka | Physical Therapist | 2421 Ira E Woods Ave #101, Grapevine, TX 76051 | 2020-02-12 |
| 1871137562 | Karen Lorince | Counselor | 2409 N. Support Road, Grapevine, TX 76051 | 2019-11-05 |
| 1548733785 | Jessica Thorman Johnson | Dietitian, Registered | 1056 Texan Trail (fortis Bmi), Grapevine, TX 76051 | 2019-01-10 |
| 1164928958 | Kristen Diou | Counselor | 913 S Church St Ste 103, Grapevine, TX 76051 | 2018-04-02 |
| 1356860597 | Anissa Singratanakul D.m.d, Pllc | Dentist | 1231 William D Tate Suite 400, Grapevine, TX 76051 | 2017-09-19 |
| 1033637665 | James Abraham Thomas | Pharmacy | 1601 W. State Hwy 114, Grapevine, TX 76051 | 2017-09-04 |
| 1437606563 | D'anna Sims | Counselor | 2451 Stone Myers Parkway, #100, Grapevine, TX 76051 | 2016-09-07 |
| 1477006369 | Melinda Jeanne Mashburn | Nurse Practitioner | 1600 West College St., Suite 60, Grapevine, TX 76051 | 2016-07-27 |
| 1437506623 | Allcare Physicians Group | Registered Nurse | 1111 S Main St Ste 119, Grapevine, TX 76051 | 2016-05-18 |
| 1790141745 | Colwick Counseling | Clinic/Center | 1400 W. Northwest Highway Suite 260, Grapevine, TX 76051 | 2016-01-06 |
| Find all providers in zip 76051 | ||||
| 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 |
|---|---|---|---|---|
| 1831552389 | Ntkc-dfw,pllc | Internal Medicine | 3801 William D Tate Ave, Suite 105, Grapevine, TX 76051-8755 | 2016-04-01 |
| 1891948683 | Ntkc Management, LLC | Internal Medicine | 1601 Lancaster Dr, Suite 20c, Grapevine, TX 76051-2109 | 2008-10-24 |
| 1376735829 | Ntkc Management, LLC | Internal Medicine | 1600 W College St, Suite 410, Grapevine, TX 76051-3580 | 2007-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203659 | Nephrology and Hypertension Specialists Pa | Internal Medicine | 4102 Woodlawn Ave Ste 220, Pasadena, TX 77504-1949 | 2020-10-22 |
| 1437781960 | Haus Medical Group Pllc | Internal Medicine | 1315 St Joseph Pkwy Ste 1704, Houston, TX 77002-8238 | 2020-02-12 |
| 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.