| Organization Name: | SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP, P.L.L.C. |
| NPI Number: | 1144553868 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLAY ROBY (EXECUTIVE DIRECTOR) |
| Mailing Address: | 602 31st St Hondo |
| State: | TX US |
| Postal Code: | 788613512 |
| Phone Number: | 2106927228 |
| Fax Number: | 2106929671 |
| NPI Enumeration Date: | 09/14/2009 |
| NPI Last Update Date: | 04/10/2014 |
| 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: | |