Provider Demographics
NPI:1477548857
Name:UROLOGY SPECIALISTS OF AUSTIN,LLP
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS OF AUSTIN,LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSPEH
Authorized Official - Last Name:HORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-477-5905
Mailing Address - Street 1:3100 RED RIVER ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3245
Mailing Address - Country:US
Mailing Address - Phone:512-477-5905
Mailing Address - Fax:512-477-8640
Practice Address - Street 1:3100 RED RIVER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3245
Practice Address - Country:US
Practice Address - Phone:512-477-5905
Practice Address - Fax:512-477-8640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00454YMedicare ID - Type Unspecified
TXOOK47DMedicare ID - Type UnspecifiedGROUP PROVIDER NUMBER