EAST TEXAS KIDNEY SPECIALISTSPA NPI 1184689622

NPI Information

NPI: 1184689622
Provider Name: EAST TEXAS KIDNEY SPECIALISTS,PA
Classification: Internal Medicine - 207RN0300X
Specialization: Nephrology
Entity Type: Organization
Doing Business As: EAST TEXAS KIDNEY SPECIALISTS
Address: 3535 N FOURTH ST STE 301
LONGVIEW, TX
ZIP 75605
Phone: (903) 234-9992

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NPI Details

EAST TEXAS KIDNEY SPECIALISTS,PA is a nephrology internal medicine in Longview, TX. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. EAST TEXAS KIDNEY SPECIALISTS,PA NPI is 1184689622. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As East Texas Kidney Specialists.

The provider's business location address is:

3535 N FOURTH ST STE 301
LONGVIEW, TX
ZIP 75605-037
Phone: (903) 234-9992
Fax: (903) 234-8287

The provider's authorized official is Tiffany Hagood .
The authorized official title is Practice Administrator and has the following contact phone number (903) 234-9992.

The enumeration date for this NPI number is 4/18/2006 and was last updated on 10/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RN0300X	Internal Medicine	Nephrology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0035GN	OTHER	TEXAS	BLUE CROSS & BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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