Kidd Medical Concepts PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M1829 Issued in TX

Legal business name

KIDD MEDICAL CONCEPTS PLLC

Practice address

2900 McKinnon St Apt 502
Dallas, TX 75201-1064

Phone

(972) 505-1584

NPI assigned

Jan 25, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Avian Deshiver Kidd, MD

Title

President & Provider

Phone

(972) 505-1584

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1437454352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8887",
            "city": "GREENVILLE",
            "state": "TX",
            "postal_code": "754048887",
            "telephone_number": "903-200-1277",
            "fax_number": "903-269-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MCKINNON ST APT 502",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752011064",
            "telephone_number": "972-505-1584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 McKinney Ave Ste 700",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752021241",
            "country_code": "US",
            "telephone_number": "972-505-1584",
            "fax_number": "844-582-3627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KIDD MEDICAL CONCEPTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "KIDD",
        "authorized_official_first_name": "AVIAN",
        "authorized_official_middle_name": "DESHIVER",
        "authorized_official_title_or_position": "PRESIDENT & PROVIDER",
        "authorized_official_telephone_number": "972-505-1584",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M1829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buruk Kidane
• Dawit Kidane
• Ezana Kidane
• Milla Kidane
• Yordanos Ghebremicaheal Kidane, RPH
• Avian D Kidd, M.D.
• Jocelyn Denise Kidd, D.D.S
• Kimberly Kidd
• Mehgan Kidd, MD
• Michaela Angelea Kidd, CAA

• Internal Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.