Organization Active NPI

West Texas Nephrology Associates

  • Nephrology Physician
  • San Angelo, TX
National Provider Identifier
1376548008
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
00KL07 Issued in TX
Legal business name
WEST TEXAS NEPHROLOGY ASSOCIATES
Practice address
136 E Concho Ave
San Angelo, TX 76903-5947
Phone
(325) 653-6773
Fax
(325) 653-3849
NPI assigned
Jun 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Dr. Steve F Montoya Jr., M.D.
Title
Ceo
Phone
(325) 653-6773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RN0300X 00KL07 TX Primary

Addresses

Primary practice location

136 E Concho Ave
San Angelo, TX 76903-5947

Mailing address

PO Box 5780
San Angelo, TX 76902-5780
Phone (325) 653-6773

Other identifiers 2

IdentifierTypeStateIssuer
112858904MedicaidTX
CP4155OtherTXRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

3501 Executive Dr
San Angelo, TX 76904
Phone (325) 747-8025

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1376548008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5780",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769025780",
            "telephone_number": "325-653-6773",
            "fax_number": "325-653-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 E CONCHO AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035947",
            "telephone_number": "325-653-6773",
            "fax_number": "325-653-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS NEPHROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "325-653-6773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "00KL07",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112858904",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP4155",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.