Provider Demographics
NPI:1225110323
Name:STAR UROLOGY OF TEXAS, P.A.
Entity Type:Organization
Organization Name:STAR UROLOGY OF TEXAS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:O
Authorized Official - Last Name:NWAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-980-1920
Mailing Address - Street 1:200 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165
Mailing Address - Country:US
Mailing Address - Phone:214-980-1920
Mailing Address - Fax:214-980-1686
Practice Address - Street 1:200 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:214-980-1920
Practice Address - Fax:214-980-1686
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STAR UROLOGY OF TEXAS, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8388208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079566801Medicaid
TX00016ROtherMEDICARE
TX101972102Medicaid
120561100OtherFIRST CARE
TX340018490OtherRR MEDC
8A5910OtherBCBS
TX0026E2OtherBCBS
7190018OtherAETNA
TX8168MOOtherMEDICARE
TX079566801Medicaid