Organization Active NPI

West Texas Renal Care Center Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Angelo, TX
National Provider Identifier
1609860485
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
License
006902 Issued in TX
Legal business name
WEST TEXAS RENAL CARE CENTER INC
Practice address
3501 Executive Dr
San Angelo, TX 76904-6883
Phone
(325) 949-5081
NPI assigned
Sep 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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.NPI 1699770313
Title
Ceo
Phone
(325) 653-6773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X 006902 TX Primary

Addresses

Primary practice location

3501 Executive Dr
San Angelo, TX 76904-6883

Mailing address

136 E Concho Ave
San Angelo, TX 76903-5947
Phone (325) 653-6773

Other identifiers 2

IdentifierTypeStateIssuer
094270801MedicaidTX
HH6151OtherTXBCBS

National Provider Directory

National Provider Directory

Locations

136 E Concho Ave
San Angelo, TX 76903
Phone (325) 653-6773

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328227200000",
    "number": "1609860485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 E CONCHO AVE",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769035947",
            "telephone_number": "325-653-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 EXECUTIVE DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046883",
            "telephone_number": "325-949-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST TEXAS RENAL CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2012-02-03",
        "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": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "TX",
            "license": "006902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "094270801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "HH6151",
            "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 Feb 3, 2012; 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.