Provider Demographics
NPI:1497981211
Name:ADVANCED KIDNEY CARE OF NORTH TEXAS, P.L.L.C.
Entity Type:Organization
Organization Name:ADVANCED KIDNEY CARE OF NORTH TEXAS, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIEDERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-587-2149
Mailing Address - Street 1:4708 ALLIANCE BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5368
Mailing Address - Country:US
Mailing Address - Phone:469-467-0011
Mailing Address - Fax:469-467-4923
Practice Address - Street 1:4708 ALLIANCE BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5368
Practice Address - Country:US
Practice Address - Phone:469-467-0011
Practice Address - Fax:469-467-4923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3581207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0A5851Medicare PIN