KIDNEY TREATMENT CENTER NORTHWEST P A NPI 1568466506

NPI Information

NPI: 1568466506
Provider Name: KIDNEY TREATMENT CENTER NORTHWEST P A
Classification: Clinic/Center - 261QE0700X
Entity Type: Organization

Specialization: End-Stage Renal Disease (ESRD) Treatment

Address:
3939 MEDICAL DR
STE 110
SAN ANTONIO, TX
ZIP 78229
Phone: (210) 692-3075
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KIDNEY TREATMENT CENTER NORTHWEST P A is an end-stage renal disease (esrd) treatment clinic center in San Antonio, TX. KIDNEY TREATMENT CENTER NORTHWEST P A NPI is 1568466506. The provider is registered as an organization entity type.

The provider's business location address is:

3939 MEDICAL DR
STE 110
SAN ANTONIO, TX
ZIP 78229-292
Phone: (210) 692-3075
Fax: (210) 692-0187

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 1/25/2012.

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	007316	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	C13784	MEDICARE UPIN
2	HH6407	OTHER	TEXAS	BCBS
3	1452880-02	MEDICAID	TEXAS
4	452829	MEDICARE ID-TYPE UNSPECIFIED	TEXAS
5	0943250-02	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

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