North Texas Renal Clinic, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

008212 Issued in TX

Legal business name

NORTH TEXAS RENAL CLINIC, LLC

Practice address

4309 Mesa Dr
Denton, TX 76207-3457

Phone

(940) 566-2701

Fax

(940) 382-2558

NPI assigned

Nov 23, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Dan Michael Corpany, BS, PA,CNT

Title

President

Phone

(940) 566-2701

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• North Texas Renal Clinic, LLC Doing business as

Locations

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295718229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4309 MESA DR",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762073457",
            "telephone_number": "940-566-2701",
            "fax_number": "940-382-2558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4309 MESA DR",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762073457",
            "telephone_number": "940-566-2701",
            "fax_number": "940-382-2558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS RENAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CORPANY",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-566-2701",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS, PA,CNT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "008212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "008212",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Texas Renal Clinic, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Denton, TX
• Providers in Denton, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.