KIDNEY TREATMENT CENTER SAN ANTONIO INC NPI 1225032253

NPI Information

NPI: 1225032253
Provider Name: KIDNEY TREATMENT CENTER SAN ANTONIO INC
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
803 CASTROVILLE RD
STE 401
SAN ANTONIO, TX
ZIP 78237
Phone: (210) 435-4725
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KIDNEY TREATMENT CENTER SAN ANTONIO INC is an end-stage renal disease (esrd) treatment clinic center in San Antonio, TX. KIDNEY TREATMENT CENTER SAN ANTONIO INC NPI is 1225032253. The provider is registered as an organization entity type.

The provider's business location address is:

803 CASTROVILLE RD
STE 401
SAN ANTONIO, TX
ZIP 78237-148
Phone: (210) 435-4725
Fax: (210) 433-8826

The provider's authorized official is Jessica J Medola .
The authorized official title is Supervisor and has the following contact phone number (210) 692-1515.

The enumeration date for this NPI number is 6/8/2005 and was last updated on 4/7/2010.

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	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment	000043	TEXAS	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	HH6150	OTHER	TEXAS	BC/BS
2	C13784	MEDICARE UPIN	TEXAS
3	452615	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
4	0210833-01	MEDICAID	TEXAS
5	0878423-01	MEDICAID	TEXAS

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: 4/28/2024

NPI Synchronization or Removal

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