Provider Demographics
NPI:1609233618
Name:UDA PLLC
Entity Type:Organization
Organization Name:UDA PLLC
Other - Org Name:URSO KRAMR LLP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEMBER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KRAMR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:979-846-0353
Mailing Address - Street 1:4011 S TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-4022
Mailing Address - Country:US
Mailing Address - Phone:979-846-0353
Mailing Address - Fax:979-846-4908
Practice Address - Street 1:4011 S TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-4022
Practice Address - Country:US
Practice Address - Phone:979-846-0353
Practice Address - Fax:979-846-4908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX189641223G0001X
TX238531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty