Provider Demographics
NPI:1225225246
Name:UROLOGY AND ROBOTICS CENTER PA
Entity Type:Organization
Organization Name:UROLOGY AND ROBOTICS CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:GIRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLABHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-790-5897
Mailing Address - Street 1:PO BOX 94108
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79493-4108
Mailing Address - Country:US
Mailing Address - Phone:806-790-5897
Mailing Address - Fax:806-687-0380
Practice Address - Street 1:4009 19TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1003
Practice Address - Country:US
Practice Address - Phone:806-790-5897
Practice Address - Fax:806-687-0380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6672208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty