Organization
SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA AGUIRRE (ASSISTANCE ADMINISTRATOR)
(210) 661-5622
Entity
Organization
Contact information
Practice address
7142 SAN PEDRO AVE, STE 120, SAN ANTONIO, TX 78216-6256
(210) 661-5622
(210) 798-6811
Mailing address
7142 SAN PEDRO AVE, STE 120, SAN ANTONIO, TX 78216-6256
(210) 661-5622
(210) 798-6811
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097331503
—
TX
01
—
CC8120
MEDICARE RAILROAD
TX
Enumeration date
12/06/2005
Last updated
02/07/2013
Update your record
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