Tyler Kidney Doctors PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

J8518 Issued in TX

Legal business name

TYLER KIDNEY DOCTORS PA

Practice address

700 Olympic Plaza Cir
912
Tyler, TX 75701-1951

Phone

(903) 594-2293

Fax

(903) 848-9513

NPI assigned

Oct 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert C Dobrowolski, M.D.

Title

Physician

Phone

(903) 594-2293

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Michael McGovern, MD

  • Surgery Physician
  • Tyler, TX
  • NPI 1780606905
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1023198637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 132506",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757132506",
            "telephone_number": "903-594-2293",
            "fax_number": "903-566-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR",
            "address_2": "912",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011951",
            "telephone_number": "903-594-2293",
            "fax_number": "903-848-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER KIDNEY DOCTORS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "DOBROWOLSKI",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "903-594-2293",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "J8518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0032NC",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tyler Independent School District
• Tyler Inpatient Management Specialists, PA
• Tyler Integrated Physical Therapy, LLC
• Tyler Integrative Health and Wellness, LLC
• Tyler Internal Medicine Associates, P.a.
• Tyler Massage, LLC
• Tyler Nephrology Associates, P.a.
• Tyler Neurosurgical Associates, P.a.
• Tyler Obstetrics and Gynecology L L P
• Tyler Office of Pediatrics P a

• Nephrology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.