Provider Demographics
NPI:1265477152
Name:KIDNEY CARE ASSOCIATES LLP
Entity Type:Organization
Organization Name:KIDNEY CARE ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WIRASAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HASNAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-893-7170
Mailing Address - Street 1:600 E TAYLOR ST STE 103
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2810
Mailing Address - Country:US
Mailing Address - Phone:903-893-7170
Mailing Address - Fax:903-893-4372
Practice Address - Street 1:600 E TAYLOR ST STE 103
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2810
Practice Address - Country:US
Practice Address - Phone:903-893-7170
Practice Address - Fax:903-893-4372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0858207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185866401Medicaid
OK200118650AMedicaid
TX122390106Medicaid
TX166853502Medicaid
OK200118660AMedicaid
TX118143005Medicaid
TX185865601Medicaid