| Southern California Kidney Care Pc | |
|
5605 N Macarthur Blvd Fl 10 Irving TX 75038-2617 | |
| (972) 460-0910 | |
| Not Available |
| Full Name | Southern California Kidney Care Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5605 N Macarthur Blvd Fl 10, Irving, Texas |
| Authorized Official Name and Position | Allie Silver (VP, CENTRAL SERVICES) |
| Authorized Official Contact | 4044085442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern California Kidney Care Pc 1125 17th St Ste 1000 Denver CO 80202-2043 Ph: (720) 204-5760 | Southern California Kidney Care Pc 5605 N Macarthur Blvd Fl 10 Irving TX 75038-2617 Ph: (972) 460-0910 |
| NPI Number | 1801532528 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 07/07/2025 |
| Medicare PECOS PAC ID | 4981075827 |
|---|---|
| Medicare Enrollment ID | O20230201000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801532528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Osarugue Cassandra Aigbogun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578114617 PECOS PAC ID: 5395170377 Enrollment ID: I20200122000151 |
| Provider Name | Kimberly Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972860591 PECOS PAC ID: 2264829761 Enrollment ID: I20220503000105 |
| Provider Name | Vibhuti J Patel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1629723481 PECOS PAC ID: 6002200102 Enrollment ID: I20230530002505 |
| Provider Name | Samantha M Walton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568013928 PECOS PAC ID: 5193159168 Enrollment ID: I20231128000352 |
| Provider Name | Christine A Gallup |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083981831 PECOS PAC ID: 8224422597 Enrollment ID: I20231204003537 |
| Provider Name | Johanna C De Jesus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821711169 PECOS PAC ID: 2668842550 Enrollment ID: I20231228003688 |
| Provider Name | Siglinda R Marlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952301186 PECOS PAC ID: 5092899740 Enrollment ID: I20240405001908 |
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