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Organization

NTKC - DFW, PLLC

Active
Other names
North Texas Kidney Consultants
Organization subpart
No

Provider details

NPI number
Authorized official
DAN N BACCUS (CFO)
(817) 488-6669
Entity
Organization

Contact information

Practice address
7250 HAWKINS VIEW DR, SUITE 410, FORT WORTH, TX 76132-3920
(817) 294-0280
(817) 294-2084
Mailing address
3801 WILLIAM D TATE AVE STE 105, GRAPEVINE, TX 76051-8755
(817) 488-6812
(817) 251-1303

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
209283502
TX
Enumeration date
08/29/2011
Last updated
06/27/2019
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