Basic Information
| Provider Information | |||||||||
| NPI: | 1477548857 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UROLOGY SPECIALISTS OF AUSTIN,LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 RED RIVER ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787053245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124775905 | ||||||||
| FaxNumber: | 5124778640 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 RED RIVER ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787053245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124775905 | ||||||||
| FaxNumber: | 5124778640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HORAN | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | JOSPEH | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5124775905 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.