Organization Active NPI

SNG - Columbia Square Dialysis Center LP

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Antonio, TX
National Provider Identifier
1588071435
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
SNG - COLUMBIA SQUARE DIALYSIS CENTER LP
Practice address
1711 Columbia SQ
San Antonio, TX 78227-2417
Phone
(210) 455-8836
Fax
(210) 455-8799
NPI assigned
Jul 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Kinam C. Martin
Title
Chief Operations Officer
Phone
(817) 725-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

1711 Columbia SQ
San Antonio, TX 78227-2417

Mailing address

1000 W Cannon St
Fort Worth, TX 76104-3029
Phone (817) 725-7900

Other identifiers 1

IdentifierTypeStateIssuer
110339OtherTXFACILITY LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1588071435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043029",
            "telephone_number": "817-725-7900",
            "fax_number": "682-207-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 COLUMBIA SQ",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782272417",
            "telephone_number": "210-455-8836",
            "fax_number": "210-455-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNG - COLUMBIA SQUARE DIALYSIS CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KINAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIEF OPERATIONS OFFICER",
        "authorized_official_telephone_number": "817-725-7900"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FACILITY LICENSE",
            "identifier": "110339",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.