Organization
WICHITA FALLS KIDNEY CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYASANKAR KALUVAPELLE REDDY M.D. (OWNER)
(512) 777-9650
Entity
Organization
Contact information
Practice address
1508 10TH ST, WICHITA FALLS, TX 76301-4401
(940) 263-1286
Mailing address
1508 10TH ST, WICHITA FALLS, TX 76301-4401
(940) 263-1286
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
03/16/2011
Last updated
12/20/2012
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