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NACOGDOCHES NEPHROLOGY, PA
NPI 1710120167
Specialist in Nacogdoches, TX

Active since April 15, 2009
626 RUSSELL BLVD, SUITE B, NACOGDOCHES, TX 75965(936) 552-7216(936) 552-7274 Get Directions Write a Review

NPPES record last updated: April 15, 2009. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Nacogdoches Nephrology, Pa NPPES

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

NACOGDOCHES NEPHROLOGY, PA (NPI 1710120167) is a healthcare organization registered as a specialist in Nacogdoches, Texas and active in the NPI registry since April 2009. The organization lists Dolamu O. B. Sokunbi, Nephrologist, as its authorized official.

NPPES Registry Identity

NPI1710120167
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameNACOGDOCHES NEPHROLOGY, PA
Location Address626 RUSSELL BLVD, SUITE BNacogdoches, TX 75965-1246
Mailing Address626 Russell Blvd, Suite BNacogdoches, TX 75965-1246 · (936) 552-7216 · Fax (936) 552-7274
Phone(936) 552-7216
Fax(936) 552-7274
Organization SubpartNo
Authorized OfficialDolamu O. B. SokunbiNephrologist · (936) 552-7216
Enumeration DateApril 15, 2009
✔ NPI 1710120167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TX · J7203
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
626 RUSSELL BLVD, Nacogdoches, TX 75965
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Other Identifiers 2

Medicare UPINF86783TX
Medicaid113679803TX

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nacogdoches Nephrology, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Nacogdoches Nephrology, PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Dolamu Sokunbi, M.D.
Nephrology
NPI 1942276001
626 RUSSELL BLVD SUITE B
Nacogdoches, TX 75965
(936) 552-7216
✔ PECOSSame address
Carriston Hendricks, FNP-C
Nurse Practitioner
NPI 1750820296
1743 SOUTHVIEW CIR
Center, TX 75935
(936) 590-4708
✔ PECOS✔ Accepts Medicare29 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Nacogdoches Nephrology, PA's NPI number?

The NPI number for Nacogdoches Nephrology, PA is 1710120167. It was assigned to this organization in the NPPES registry on April 15, 2009.

Where is Nacogdoches Nephrology, PA located?

Nacogdoches Nephrology, PA is located at 626 Russell Blvd Suite B, Nacogdoches, TX 75965. The listed phone number is (936) 552-7216.

What is Nacogdoches Nephrology, PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Nacogdoches Nephrology, PA enrolled in Medicare?

Yes. Nacogdoches Nephrology, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Nacogdoches Nephrology, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Nacogdoches Nephrology, PA, in Nephrology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Nacogdoches Nephrology, PA was last updated on April 15, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.