Provider Demographics
NPI:1275559874
Name:COLLIN COUNTY UROLOGY
Entity Type:Organization
Organization Name:COLLIN COUNTY UROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-596-6733
Mailing Address - Street 1:1220 COIT ROAD
Mailing Address - Street 2:STE 107
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-7757
Mailing Address - Country:US
Mailing Address - Phone:972-596-6733
Mailing Address - Fax:972-964-3591
Practice Address - Street 1:1220 COIT ROAD
Practice Address - Street 2:STE 107
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-7757
Practice Address - Country:US
Practice Address - Phone:972-596-6733
Practice Address - Fax:972-964-3591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD7972208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00BF12Medicare ID - Type Unspecified
C15765Medicare UPIN