Provider Demographics
NPI:1578728531
Name:NORTHWEST UROLOGY ASSOCIATES, PLC
Entity Type:Organization
Organization Name:NORTHWEST UROLOGY ASSOCIATES, PLC
Other - Org Name:NORTHWEST IMAGING
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERVISING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BIREN
Authorized Official - Middle Name:GIRISH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-544-5920
Mailing Address - Street 1:14674 W MOUNTAIN VIEW BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-2706
Mailing Address - Country:US
Mailing Address - Phone:623-544-5920
Mailing Address - Fax:623-544-5921
Practice Address - Street 1:14674 W MOUNTAIN VIEW BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-2706
Practice Address - Country:US
Practice Address - Phone:623-544-5920
Practice Address - Fax:623-544-5921
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST UROLOGY ASSOCIATES, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7-M83422085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty