Organization
ANGELO KIDNEY CONNECTION, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELANIE L. BAUMGARTNER RN (ADMINISTRATOR/CEO)
(325) 617-2496
Entity
Organization
Contact information
Practice address
2901 SHERWOOD WAY, SUITE 100, SAN ANGELO, TX 76901-3586
(326) 617-2496
(325) 617-2497
Mailing address
P.O. BOX 61074, SAN ANGELO, TX 76906-1074
(325) 617-2496
(325) 617-2497
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
8643
TX
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1948945
—
TX
Enumeration date
02/05/2008
Last updated
09/10/2010
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