Provider Demographics
NPI:1619917119
Name:ROBERT J CORNELL MD PA
Entity Type:Organization
Organization Name:ROBERT J CORNELL MD PA
Other - Org Name:WESLACO UROLOGY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:CORNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-968-9596
Mailing Address - Street 1:1330 E 6TH ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4204
Mailing Address - Country:US
Mailing Address - Phone:956-968-9596
Mailing Address - Fax:956-969-2513
Practice Address - Street 1:1330 E 6TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-4204
Practice Address - Country:US
Practice Address - Phone:956-968-9596
Practice Address - Fax:956-969-2513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty