Provider Demographics
NPI:1528261831
Name:KIDNEY COUNSULTANTS LLC
Entity type:Organization
Organization Name:KIDNEY COUNSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:URIBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-464-8712
Mailing Address - Street 1:200 W ESPLANADE
Mailing Address - Street 2:#103
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065
Mailing Address - Country:US
Mailing Address - Phone:504-464-8712
Mailing Address - Fax:504-464-8711
Practice Address - Street 1:200 W ESPLANADE
Practice Address - Street 2:#103
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065
Practice Address - Country:US
Practice Address - Phone:504-464-8712
Practice Address - Fax:504-464-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5D909Medicare ID - Type Unspecified
LA1945714Medicare ID - Type Unspecified