NTKC Management, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

NTKC MANAGEMENT, LLC

Doing business as

North Texas Kidney Consultants

Practice address

3515 Swiss Ave
Second Floor
Dallas, TX 75204-6223

Phone

(469) 467-0011

Fax

(469) 467-4923

NPI assigned

Aug 17, 2007

Last updated

May 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dan Baccus

Title

Chief Operating Officer

Phone

(817) 375-0610

Specialties & licenses 1

Addresses

Other names 1

• North Texas Kidney Consultants Doing business as

Locations

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1518159052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 MATLOCK RD",
            "address_2": "SUITE 205",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760152935",
            "telephone_number": "817-375-0610",
            "fax_number": "817-375-0640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 SWISS AVE",
            "address_2": "SECOND FLOOR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046223",
            "telephone_number": "469-467-0011",
            "fax_number": "469-467-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NTKC MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "BACCUS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "817-375-0610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Texas Kidney Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nephrology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Nephrology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.