| Organization Name: | SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C. |
| NPI Number: | 1114045846 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLAY ROBY (EXECUTIVE DIRECTOR) |
| Mailing Address: | 32665 Hwy 281 N Ste 206 Bulverde |
| State: | TX US |
| Postal Code: | 781633124 |
| Phone Number: | 2106547326 |
| Fax Number: | 2105908232 |
| NPI Enumeration Date: | 03/27/2007 |
| NPI Last Update Date: | 09/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |