Organization
CENTRAL TEXAS KIDNEY ASSOCIATES
Active
Other names
CENTRAL TEXAS KIDNEY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DONNELLY ADM (ADM)
(512) 451-5800
Entity
Organization
Contact information
Practice address
408 W 45TH ST, AUSTIN, TX 78751-3014
(512) 451-5800
(512) 451-5800
Mailing address
408 W 45TH ST, AUSTIN, TX 78751-3014
(512) 451-5800
(512) 451-5800
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1700816923
00R28H
TX
Enumeration date
07/04/2006
Last updated
10/29/2012
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