Organization
KIDNEY DISEASE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN DARIO VILLA (MD)
(806) 368-6391
Entity
Organization
Contact information
Practice address
5424 19TH ST # 403, LUBBOCK, TX 79407-2162
(806) 368-8782
(806) 368-8361
Mailing address
5424 19TH ST # 403, LUBBOCK, TX 79407-2162
(806) 368-8782
(806) 368-8361
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
094914101
—
TX
Enumeration date
09/23/2005
Last updated
06/04/2024
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