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SOUTHLAKE KIDNEY SPECIALISTS, PLLC
NPI 1003465790
Internal Medicine - Nephrology in Southlake, TX

Active since September 05, 2019
630 N KIMBALL AVE STE 100, SOUTHLAKE, TX 76092(817) 733-9367 Get Directions Write a Review

NPPES record last updated: January 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 29, 2020, Sep 5, 2019 (2 updates tracked since 2019).

About Southlake Kidney Specialists, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHLAKE KIDNEY SPECIALISTS, PLLC (NPI 1003465790) is a healthcare organization registered as a nephrology in Southlake, Texas and active in the NPI registry since September 2019. The organization lists Sharmila Devidoss, Physician, as its authorized official.

NPPES Registry Identity

NPI1003465790
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameSOUTHLAKE KIDNEY SPECIALISTS, PLLC
Location Address630 N KIMBALL AVE STE 100Southlake, TX 76092-6886
Mailing Address701 Monte Carlo DrSouthlake, TX 76092-1159 · (817) 733-9367
Phone(817) 733-9367
Organization SubpartNo
Authorized OfficialSharmila DevidossPhysician · (817) 733-9367
Enumeration DateSeptember 5, 2019
Last NPPES UpdateJanuary 29, 20202 updates tracked since enumeration
✔ NPI 1003465790 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
630 N KIMBALL AVE STE 100, Southlake, TX 76092
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRANDY HOFFMAN STRANGE MD
Family Medicine
630 N KIMBALL AVE STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 421-8777
KEITH VINCENT MCINNERNEY PA-C
Physician Assistant (Medical)
630 N KIMBALL AVE STE 100
SOUTHLAKE, TX 76092
Tarrant County (817) 421-8777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southlake Kidney Specialists, PLLC's NPI number?

The NPI number for Southlake Kidney Specialists, PLLC is 1003465790. It was assigned to this organization in the NPPES registry on September 5, 2019.

Where is Southlake Kidney Specialists, PLLC located?

Southlake Kidney Specialists, PLLC is located at 630 N Kimball Ave Ste 100, Southlake, TX 76092. The listed phone number is (817) 733-9367.

What is Southlake Kidney Specialists, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

What insurance does Southlake Kidney Specialists, PLLC accept?

Health plans from Molina Healthcare list Southlake Kidney Specialists, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southlake Kidney Specialists, PLLC was last updated on January 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.