Provider Demographics
NPI:1417282609
Name:AMERICAN INSTITUTE FOR UNRINARY INCONTINENCE
Entity Type:Organization
Organization Name:AMERICAN INSTITUTE FOR UNRINARY INCONTINENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-458-2484
Mailing Address - Street 1:12800 PRESTON RD
Mailing Address - Street 2:STE 201
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1365
Mailing Address - Country:US
Mailing Address - Phone:972-458-2484
Mailing Address - Fax:
Practice Address - Street 1:12800 PRESTON RD
Practice Address - Street 2:STE 201
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1365
Practice Address - Country:US
Practice Address - Phone:972-458-2484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9806207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty