Organization Active NPI

Metroplex Nephrology Associates, PLLC

  • Nephrology Physician
  • Plano, TX
National Provider Identifier
1174777858
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
TXL7183 Issued in TX
Legal business name
METROPLEX NEPHROLOGY ASSOCIATES, PLLC
Practice address
4100 W 15TH St
Suite 100
Plano, TX 75093-5803
Phone
(972) 612-0010
Fax
(972) 612-0025
NPI assigned
Nov 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Authorized official

Name
Nadeem Ahmad Siddiqui, MD
Title
President/Ceo
Phone
(972) 612-0010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X TXL7183 TX Primary

Addresses

Primary practice location

4100 W 15TH St
Suite 100
Plano, TX 75093-5803

Mailing address

4100 W 15TH St
Suite 100
Plano, TX 75093-5803
Phone (972) 612-0010

Other identifiers 1

IdentifierTypeStateIssuer
210232901MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1226016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335916800000",
    "number": "1174777858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 W 15TH ST",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935803",
            "telephone_number": "972-612-0010",
            "fax_number": "972-612-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 15TH ST",
            "address_2": "SUITE 100",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750935803",
            "telephone_number": "972-612-0010",
            "fax_number": "972-612-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METROPLEX NEPHROLOGY ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-07",
        "last_updated": "2012-05-02",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "NADEEM",
        "authorized_official_middle_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "972-612-0010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "TXL7183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210232901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2012; 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.