NPIMap

Organization Active NPI

North Texas Kidney Disease Associates

  • Nephrology Physician
  • Flower Mound, TX
National Provider Identifier
1528824786
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
NORTH TEXAS KIDNEY DISEASE ASSOCIATES
Practice address
4491 Long Prairie Rd Ste 200
Flower Mound, TX 75028-2012
Phone
(469) 645-0202
Fax
(972) 539-4851
NPI assigned
Feb 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Sirena Martin
Title
Practice Manager
Phone
(972) 219-0558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

4491 Long Prairie Rd Ste 200
Flower Mound, TX 75028-2012

Mailing address

1600 Waters Ridge Dr Ste a
Lewisville, TX 75057-6039
Phone (972) 219-0558

National Provider Directory

National Provider Directory
Tax ID family
North TX Kidney Disease10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1528824786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 WATERS RIDGE DR STE A",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750576039",
            "telephone_number": "972-219-0558",
            "fax_number": "214-466-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 LONG PRAIRIE RD STE 200",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750282012",
            "telephone_number": "469-645-0202",
            "fax_number": "972-539-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS KIDNEY DISEASE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "SIRENA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "972-219-0558"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.