Provider Demographics
NPI:1255985156
Name:DFW KIDNEY CARE CLINIC LLC
Entity type:Organization
Organization Name:DFW KIDNEY CARE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NISHANT
Authorized Official - Middle Name:
Authorized Official - Last Name:JALANDHARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-912-5900
Mailing Address - Street 1:117 GEMINI CIR STE 404
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5850
Mailing Address - Country:US
Mailing Address - Phone:888-212-4243
Mailing Address - Fax:
Practice Address - Street 1:4375 BOOTH CALLOWAY RD STE 208
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8362
Practice Address - Country:US
Practice Address - Phone:888-212-4243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-29
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty