NPIMap

Organization Active NPI

San Antonio Kidney Disease Center Physicians Group, P.L.L.C.

  • Nephrology Physician
  • Live Oak, TX
National Provider Identifier
1700904612
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.
Practice address
6700 Randolph Blvd
Suite 102
Live Oak, TX 78233-4222
Phone
(210) 654-7326
Fax
(210) 646-0042
NPI assigned
Mar 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

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

Authorized official

Name
Mr. Clay Roby
Title
Executive Director
Phone
(210) 481-7453

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

6700 Randolph Blvd
Suite 102
Live Oak, TX 78233-4222

Mailing address

7142 San Pedro Ave
Ste 120
San Antonio, TX 78216-6256
Phone (210) 481-7453

National Provider Directory

National Provider Directory
Tax ID family
San Antonio Kidney Disease Center Physicians Group PLLC32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397088000000",
    "number": "1700904612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7142 SAN PEDRO AVE",
            "address_2": "STE 120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166256",
            "telephone_number": "210-481-7453",
            "fax_number": "210-481-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 RANDOLPH BLVD",
            "address_2": "SUITE 102",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334222",
            "telephone_number": "210-654-7326",
            "fax_number": "210-646-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-04-10",
        "status": "A",
        "authorized_official_last_name": "ROBY",
        "authorized_official_first_name": "CLAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "210-481-7453",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; 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.