Provider Demographics
NPI:1235473943
Name:SKILLED KIDNEY CARE, PLLC
Entity Type:Organization
Organization Name:SKILLED KIDNEY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:SASTRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-668-5400
Mailing Address - Street 1:7460 WARREN PKWY
Mailing Address - Street 2:160
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:972-668-5400
Mailing Address - Fax:972-668-5401
Practice Address - Street 1:7460 WARREN PKWY
Practice Address - Street 2:160
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:972-668-5400
Practice Address - Fax:972-668-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty