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Kidus T Kidankal

Physician β€’ Round Rock, TX

Deactivated NPI 1639876352 Deactivated in NPPES Male Practitioner
Practice location in NPPES

1300 Gattis School Rd Ste 300
Round Rock, TX 786647472

Phone: 7034596629

Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of May 26, 2024; the reason is not published. The records below are historical. They do not show whether Kidus Kidankal currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date February 13, 2023
NPI Deactivation Date May 26, 2024
NPI Active Period 2023 – 2024

Practice Location & Contact Primary Location

Practice Address

1300 Gattis School Rd Ste 300

Round Rock, TX 786647472

Telephone 7034596629
Organization at the Same NPPES Address or Phone
Ktk Transport Llc Facility NPI 1508612326

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2023

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Compared with the same specialty in Round Rock and Texas

Comparisons are not shown because NPPES lists this NPI as deactivated.

Sources: CMS Doctors and Clinicians, CMS release of October 2, 2026, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Non-emergency Medical Transport (VAN) Primary Specialty

NUCC Taxonomy Code: 343900000X

License # reported to NPPES TX 47102757

A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Texas Medical Board.
Look Up on State Board Site

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
⚠️
NPI Profile Deactivated May 26, 2024

NPPES lists this NPI as deactivated as of May 26, 2024; the reason is not published.

βœ…
NPI Profile Active February 13, 2023

NPI status registered as active in NPPES database

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Practice Location (Initial Record) February 13, 2023

Registered at 1300 GATTIS SCHOOL RD STE 300, ROUND ROCK, TX 786647472 (Tel: 7034596629)

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Business Mailing Address (Initial Record) February 13, 2023

Registered at 1300 GATTIS SCHOOL RD STE 300, ROUND ROCK, TX 786647472 (Tel: 7034596629)

πŸ‘€
Provider Name / Credentials (Initial Record) February 13, 2023

Recorded as KIDUS KIDANKAL

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 13, 2023

Non-emergency Medical Transport (VAN) (license number reported to NPPES: TX 47102757)

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Initial NPI Registration & Enumeration February 13, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1639876352
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 13, 2023
Last Update: February 13, 2023
Deactivation Date: May 26, 2024

Mailing Address

1300 Gattis School Rd Ste 300

Round Rock, TX 786647472

Phone: 7034596629

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.