| Kidney And Primary Care Of Texas Llc | |
|
3939 Medical Dr Ste 110 San Antonio TX 78229-2292 | |
| (210) 858-7604 | |
| (210) 888-0383 |
| Full Name | Kidney And Primary Care Of Texas Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3939 Medical Dr Ste 110, San Antonio, Texas |
| Authorized Official Name and Position | Srinath Tamirisa (OWNER) |
| Authorized Official Contact | 9169476491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kidney And Primary Care Of Texas Llc 3939 Medical Dr Ste 110 San Antonio TX 78229-2292 Ph: (210) 858-7604 | Kidney And Primary Care Of Texas Llc 3939 Medical Dr Ste 110 San Antonio TX 78229-2292 Ph: (210) 858-7604 |
| NPI Number | 1689209157 |
|---|---|
| Provider Enumeration Date | 03/05/2020 |
| Last Update Date | 10/02/2023 |
| Medicare PECOS PAC ID | 5698104529 |
|---|---|
| Medicare Enrollment ID | O20200329000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689209157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Julio C Araujo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1053365023 PECOS PAC ID: 0547163503 Enrollment ID: I20061020000114 |
| Provider Name | Srinath Krishnamachary Tamirisa |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1639372949 PECOS PAC ID: 9133288798 Enrollment ID: I20111024000762 |
| Provider Name | David G Mata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790129815 PECOS PAC ID: 0749509263 Enrollment ID: I20150505002706 |
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