NORTH TEXAS KIDNEY CONSULTANTS
NPI 1063654515
Internal Medicine - Nephrology in Granbury, TX

Active since March 30, 2009CLIA Certified · 2 labs
805 HILL BLVD, SUITE 102, GRANBURY, TX 76048(817) 375-0610(817) 375-0640 Get Directions Write a Review

NPPES record last updated: March 30, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About North Texas Kidney Consultants NPPES

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

NORTH TEXAS KIDNEY CONSULTANTS (NPI 1063654515) is a healthcare organization registered as a nephrology in Granbury, Texas and active in the NPI registry since March 2009. The organization holds 2 active CLIA laboratory certificates and lists Dan Baccus, Coo, as its authorized official.

NPPES Registry Identity

NPI1063654515
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameNTKC MANAGEMENT, LLC
Location Address805 HILL BLVD, SUITE 102Granbury, TX 76048-1481
Mailing Address3030 Matlock Rd, Suite 205Arlington, TX 76015-2935 · (817) 375-0610 · Fax (817) 375-0640
Fax(817) 375-0640
Organization SubpartNo
Authorized OfficialDan BaccusCoo · (817) 375-0610
Enumeration DateMarch 30, 2009
NPI 1063654515 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.

805 HILL BLVD, Granbury, TX 76048

Other Names 1

Doing Business AsNorth Texas Kidney Consultants

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

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D1106829

North Texas Kidney Consultants-Dfw · Arlington, TX
Active · expires Oct 21, 2027
CLIA Number45D1106829
Laboratory TypePhysician Office
Certificate Effective DateOctober 22, 2025
Certificate Expiration DateOctober 21, 2027
Laboratory DirectorMajd I. Jaradat,md
Laboratory Phone(817) 375-0610
Laboratory LocationNorth Texas Kidney Consultants-Dfw4907 S Collins Street, Suite 101, Arlington, TX 76018
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D1087602

North Texas Kidney Consultants-Dfw · Bedford, TX
Active · expires Aug 6, 2026
CLIA Number45D1087602
Laboratory TypePhysician Office
Certificate Effective DateAugust 7, 2024
Certificate Expiration DateAugust 6, 2026
Laboratory DirectorDavid R. Martin
Laboratory Phone(817) 375-0610
Laboratory LocationNorth Texas Kidney Consultants-Dfw2425 Highway 121, Suite 201, Bedford, TX 76021
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

Clinic/Center (Rehabilitation)
805 HILL BLVD
GRANBURY, TX 76048
Clinic/Center (Sleep Disorder Diagnostic)
805 HILL BLVD, SUITE 107
GRANBURY, TX 76048
Durable Medical Equipment & Medical Supplies
805 HILL BLVD, SUITE 107
GRANBURY, TX 76048
Clinic/Center
805 HILL BLVD, SUITE 106
GRANBURY, TX 76048
Clinic/Center
805 HILL BLVD, SUITE 106
GRANBURY, TX 76048
Urology
805 HILL BLVD, STE 106-107
GRANDBURY, TX 76048

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 Ntkc Management, LLC's NPI number?

The NPI number for Ntkc Management, LLC is 1063654515. It was assigned to this organization in the NPPES registry on March 30, 2009. The provider is doing business as North Texas Kidney Consultants.

Where is Ntkc Management, LLC located?

Ntkc Management, LLC is located at 805 Hill Blvd Suite 102, Granbury, TX 76048. The listed phone number is (817) 375-0610.

What is Ntkc Management, LLC's specialty?

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

Does Ntkc Management, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Ntkc Management, LLC was last updated on March 30, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.