Kidney and Blood Pressure Clinic

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

F1406 Issued in TX

Legal business name

KIDNEY AND BLOOD PRESSURE CLINIC

Practice address

3939 Medical Dr
Ste 110
San Antonio, TX 78229-2292

Phone

(210) 692-1515

Fax

(210) 692-0187

NPI assigned

Jun 8, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Jessica J Medola

Title

Supervisor

Phone

(210) 692-1515

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1144224171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 MEDICAL DR",
            "address_2": "STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292292",
            "telephone_number": "210-692-1515",
            "fax_number": "210-692-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 MEDICAL DR",
            "address_2": "STE 110",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292292",
            "telephone_number": "210-692-1515",
            "fax_number": "210-692-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDNEY AND BLOOD PRESSURE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "MEDOLA",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "210-692-1515",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "F1406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "00GT38",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0828279-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Louise Kidd
• Rodney Desmond Kidd Jr., M.D.
• Robert Kidder, DO
• Kiddo Denal PA
• Kiddo Dental PA
• Kidney and Primary Care of Texas LLC
• Kidney and Wellness Center PLLC
• Kidney Treatment Center East P a
• Kidney Treatment Center Northwest P a
• Kidney Treatment Center San Antonio Inc

• Nephrology Physician in San Antonio, TX
• Providers in San Antonio, 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 26, 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.