NPIMap

Organization Active NPI

North Texas Kidney Disease Associates

  • Nephrology Physician
  • Denton, TX
National Provider Identifier
1750405197
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
3315 Colorado Blvd Ste 102
Denton, TX 76210
Phone
(940) 320-1708
Fax
(940) 565-5457
NPI assigned
Mar 19, 2007
Organization subpart
Yes
Parent organization
NORTH TEXAS KIDNEY DISEASE ASSOCIATESAs reported in NPPES

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
(144) 667-2302

Specialties & licenses 1

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

Addresses

Primary practice location

3315 Colorado Blvd Ste 102
Denton, TX 76210

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
146883702MedicaidTX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0924387North Texas Kidney Disease Associates3315 Colorado Blvd, Ste 102, Denton, TX 76210Certificate of waiverSep 9, 2026

National Provider Directory

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

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1750405197",
    "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": "3315 COLORADO BLVD STE 102",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "76210",
            "telephone_number": "940-320-1708",
            "fax_number": "940-565-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS KIDNEY DISEASE ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH TEXAS KIDNEY DISEASE ASSOCIATES",
        "enumeration_date": "2007-03-19",
        "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": "144-667-2302"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146883702",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.