NPIMap

Organization Active NPI

NTKC Management, LLC

Doing business as North Texas Kidney Consultants

  • Nephrology Physician
  • Granbury, TX
National Provider Identifier
1063654515
Registry record updated Mar 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NTKC MANAGEMENT, LLC
Doing business as
North Texas Kidney Consultants
Practice address
805 Hill Blvd
Suite 102
Granbury, TX 76048-1481
Phone
(817) 375-0610
Fax
(817) 375-0640
NPI assigned
Mar 30, 2009
Last updated
Mar 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2009

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

Authorized official

Name
Mr. Dan Baccus
Title
Coo
Phone
(817) 375-0610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

805 Hill Blvd
Suite 102
Granbury, TX 76048-1481

Mailing address

3030 Matlock Rd
Suite 205
Arlington, TX 76015-2935
Phone (817) 375-0610

Other names 1

  • North Texas Kidney Consultants Doing business as

National Provider Directory

National Provider Directory
Tax ID family
North Texas Kidney Consultants3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1238371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238371200000",
    "number": "1063654515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 MATLOCK RD",
            "address_2": "SUITE 205",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152935",
            "telephone_number": "817-375-0610",
            "fax_number": "817-375-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 HILL BLVD",
            "address_2": "SUITE 102",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760481481",
            "telephone_number": "817-375-0610",
            "fax_number": "817-375-0640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NTKC MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-30",
        "last_updated": "2009-03-30",
        "status": "A",
        "authorized_official_last_name": "BACCUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "817-375-0610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Texas Kidney Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granbury, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2009; 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.