Provider Demographics
NPI:1922756766
Name:MODERN KIDNEY AND TRANSPLANT CARE, LLC
Entity Type:Organization
Organization Name:MODERN KIDNEY AND TRANSPLANT CARE, LLC
Other - Org Name:BRIGANI AMANTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIGANI
Authorized Official - Middle Name:GARGOLLO
Authorized Official - Last Name:AMANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-478-1222
Mailing Address - Street 1:25329 INTERSTATE 45 STE 129
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3439
Mailing Address - Country:US
Mailing Address - Phone:346-478-1222
Mailing Address - Fax:346-478-1222
Practice Address - Street 1:25329 INTERSTATE 45 STE 129
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3439
Practice Address - Country:US
Practice Address - Phone:346-478-1222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-11
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty