Provider Demographics
NPI:1629195177
Name:SOUTH TEXAS KIDNEY SPECIALISTS, P.A.
Entity Type:Organization
Organization Name:SOUTH TEXAS KIDNEY SPECIALISTS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-631-6136
Mailing Address - Street 1:1901 S 1ST ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1228
Mailing Address - Country:US
Mailing Address - Phone:956-631-6136
Mailing Address - Fax:956-631-1848
Practice Address - Street 1:1901 S 1ST ST STE 600
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1228
Practice Address - Country:US
Practice Address - Phone:956-631-6136
Practice Address - Fax:956-631-1250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2427174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080227401Medicaid
TX131690304Medicaid
TX131918803Medicaid
TX100470701Medicaid
TX131918803Medicaid
TX170703602Medicaid
TXH18698Medicare UPIN
TX80062FMedicare ID - Type Unspecified
TX0024BDMedicare ID - Type Unspecified
TX080227401Medicaid
TXF88201Medicare UPIN
TX8615K0Medicare ID - Type Unspecified
TX80060FMedicare ID - Type Unspecified
TXC18729Medicare UPIN
TX100470701Medicaid
TX8G3936Medicare ID - Type Unspecified
TX131918803Medicaid