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NORTH TEXAS KIDNEY DISEASE ASSOCIATES
NPI 1790809036
Internal Medicine - Nephrology in Carrollton, TX

Active since March 19, 2007CLIA Certified · 2 labs
4240 INTERNATIONAL PKWY, STE. 154, CARROLLTON, TX 75007(469) 574-0464(469) 574-0471 Get Directions Write a Review

NPPES record last updated: July 12, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About North Texas Kidney Disease Associates NPPES

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

NORTH TEXAS KIDNEY DISEASE ASSOCIATES (NPI 1790809036) is a healthcare organization registered as a nephrology in Carrollton, Texas and active in the NPI registry since March 2007. The organization holds 2 active CLIA laboratory certificates and lists Tammy Vaughn, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1790809036
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameNORTH TEXAS KIDNEY DISEASE ASSOCIATES
Location Address4240 INTERNATIONAL PKWY, STE. 154Carrollton, TX 75007
Mailing Address3315 Colorado Blvd Ste 102Denton, TX 76210-6885 · (940) 320-1708 · Fax (940) 565-5457
Phone(469) 574-0464
Fax(469) 574-0471
Organization SubpartYes
Authorized OfficialTammy VaughnCredentialing Coordinator · (940) 320-1708
Enumeration DateMarch 19, 2007
Last NPPES UpdateJuly 12, 2018
✔ NPI 1790809036 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.
4240 INTERNATIONAL PKWY, Carrollton, TX 75007
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Other Identifiers 1

Medicaid146883702TX

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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 45D2053202

North Texas Kidney Disease Assoc · Frisco, TX
Active · expires Jan 27, 2027
CLIA Number45D2053202
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2025
Certificate Expiration DateJanuary 27, 2027
Laboratory DirectorJun Chen
Laboratory Phone(469) 574-0464
Laboratory LocationNorth Texas Kidney Disease Assoc4401 Coit Rd, Pavillion One, Suite 303, Frisco, TX 75034
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2051215

North Texas Kidney Disease Assoc · Plano, TX
Active · expires Dec 13, 2026
CLIA Number45D2051215
Laboratory TypePhysician Office
Certificate Effective DateDecember 14, 2024
Certificate Expiration DateDecember 13, 2026
Laboratory DirectorZhi Mao
Laboratory Phone(469) 574-0464
Laboratory LocationNorth Texas Kidney Disease Assoc1600 Coit Rd, Building 1, Suite 300, Plano, TX 75075
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 2

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

KELSEY ELIZABETH REEKIE AGACNP
Nurse Practitioner (Acute Care)
4240 INTERNATIONAL PKWY, SUITE 154
CARROLLTON, TX 75007
Denton County (469) 574-0464
ELISE NICOLE PORTER
Behavior Analyst
4240 INTERNATIONAL PKWY
CARROLLTON, TX 75007
Denton County (214) 296-4801

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 North Texas Kidney Disease Associates's NPI number?

The NPI number for North Texas Kidney Disease Associates is 1790809036. It was assigned to this organization in the NPPES registry on March 19, 2007.

Where is North Texas Kidney Disease Associates located?

North Texas Kidney Disease Associates is located at 4240 International Pkwy Ste. 154, Carrollton, TX 75007. The listed phone number is (469) 574-0464.

What is North Texas Kidney Disease Associates's specialty?

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

Does North Texas Kidney Disease Associates 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 North Texas Kidney Disease Associates was last updated on July 12, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.