NPIMap

Organization Active NPI

San Antonio Kidney Disease Center Physicians Group, P.L.L.C.

  • Nephrology Physician
  • Pleasanton, TX
National Provider Identifier
1114235934
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.
Practice address
1320 W Oaklawn Rd
Suite H
Pleasanton, TX 78064-4315
Phone
(830) 569-1858
Fax
(830) 569-1859
NPI assigned
Sep 14, 2010
Last updated
Apr 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Authorized official

Name
Mr. Clay Roby
Title
Executive Director
Phone
(210) 661-5622

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Nephrology Physician 207RN0300X Primary

Addresses

Primary practice location

1320 W Oaklawn Rd
Suite H
Pleasanton, TX 78064-4315

Mailing address

7142 San Pedro Ave
Suite 120
San Antonio, TX 78216-6256
Phone (210) 661-5622

National Provider Directory

National Provider Directory
Tax ID family
San Antonio Kidney Disease Center Physicians Group PLLC32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1114235934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE",
            "address_2": "SUITE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166256",
            "telephone_number": "210-661-5622",
            "fax_number": "210-481-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 W OAKLAWN RD",
            "address_2": "SUITE H",
            "city": "PLEASANTON",
            "state": "TX",
            "postal_code": "780644315",
            "telephone_number": "830-569-1858",
            "fax_number": "830-569-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "ROBY",
        "authorized_official_first_name": "CLAY",
        "authorized_official_title_or_position": "EXECUTIVE  DIRECTOR",
        "authorized_official_telephone_number": "210-661-5622",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasanton, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.