Provider Demographics
NPI:1568576882
Name:URBANEK, RICHARD A JR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:URBANEK
Suffix:JR
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 EUREKA CIR
Mailing Address - Street 2:SUITE B
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-2900
Mailing Address - Country:US
Mailing Address - Phone:940-696-2002
Mailing Address - Fax:940-696-2006
Practice Address - Street 1:5 EUREKA CIR
Practice Address - Street 2:SUITE B
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-2900
Practice Address - Country:US
Practice Address - Phone:940-696-2002
Practice Address - Fax:940-696-2006
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX196111223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1374885OtherUNITED CONCORDIA ID