Wichita Falls Kidney Clinic Pa | |
1508 10th St Wichita Falls TX 76301-4401 | |
(940) 263-1286 | |
Not Available |
Full Name | Wichita Falls Kidney Clinic Pa |
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Speciality | Internal Medicine |
Location | 1508 10th St, Wichita Falls, Texas |
Authorized Official Name and Position | Jayasankar Kaluvapelle Reddy (OWNER) |
Authorized Official Contact | 5127779650 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wichita Falls Kidney Clinic Pa 1508 10th St Wichita Falls TX 76301-4401 Ph: (940) 263-1286 | Wichita Falls Kidney Clinic Pa 1508 10th St Wichita Falls TX 76301-4401 Ph: (940) 263-1286 |
NPI Number | 1598064552 |
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Provider Enumeration Date | 03/16/2011 |
Last Update Date | 12/20/2012 |
Medicare PECOS PAC ID | 9537347299 |
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Medicare Enrollment ID | O20110628000318 |
Identifier | Type | State | Issuer |
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1598064552 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
Provider Name | Jayasankar K Reddy |
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Provider Type | Practitioner - Nephrology |
Provider Identifiers | NPI Number: 1174562276 PECOS PAC ID: 2062460827 Enrollment ID: I20100728000615 |
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