San Antonio Kidney Disease Center Physicians Group, P.L.L.C.
Internal Medicine, Nephrology in Kerrville, TX. Organization (NPI-2).
NPI number1164540134
StatusActive
Last updated in NPPESApr 10, 2014
Details
- NPI
- 1164540134
- Entity type
- Organization (NPI-2)
- Legal business name
- San Antonio Kidney Disease Center Physicians Group, P.L.L.C.
- Organization subpart
- No
- Enumeration date
- Mar 27, 2007
- Last updated
- Apr 10, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RN0300X | Internal Medicine, Nephrology | – | – | Yes |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Practice location
222 Sidney Baker SSuite 208
Kerrville, TX 78028-5994
Phone 830-896-7607 · Fax 830-896-8482
Mailing address
7142 San Pedro AveSte 120
San Antonio, TX 78216-6256
Phone 210-481-7453 · Fax 210-481-7463
Authorized official
Clay Roby
Executive Director
2104817453
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