Organization
NEPHROMED ASSOCIATES PA
Active
Other names
Nephromed associates PA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MODINAT ADEWALE (PRACTICE MANAGER)
(903) 729-1071
Entity
Organization
Contact information
Practice address
4002 S LOOP 256, STE F, PALESTINE, TX 75801-8493
(903) 723-8210
Mailing address
4002 S LOOP 256, F, PALESTINE, TX 75801-8493
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
343800000X
Secured Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
330638884
BCBS
TX
Enumeration date
08/28/2017
Last updated
05/08/2025
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