1265477152 NPI number — KIDNEY CARE ASSOCIATES LLP

Table of content: (NPI 1265477152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265477152 NPI number — KIDNEY CARE ASSOCIATES LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIDNEY CARE ASSOCIATES LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265477152
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2741 FM 691
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-893-7170
Provider Business Mailing Address Fax Number:
903-893-4372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2741 FM 691
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENISON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-893-7170
Provider Business Practice Location Address Fax Number:
903-893-4372
Provider Enumeration Date:
06/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ROPPOLO
Authorized Official First Name:
MICHELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
903-893-7170

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  G0858 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RN0300X , with the licence number: G0858 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 185866401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200118650A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 122390106 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 166853502 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200118660A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 118143005 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 185865601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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