Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southlake Kidney Specialists, PLLC

Organization Nephrology Physician · NPI 1003465790

Southlake Kidney Specialists, PLLC is a Nephrology Physician in Southlake, Texas. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

630 N Kimball Ave Ste 100
Southlake, TX 76092-6886
Phone: (817) 733-9367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X

Record details

NPI number1003465790
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sharmila Devidoss — Physician · (817) 733-9367
NPI enumeratedSeptember 5, 2019
Last updated in NPPESJanuary 29, 2020
Certification dateJanuary 29, 2020
Mailing address701 Monte Carlo Dr, Southlake, TX 76092-1159

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