Provider Demographics
NPI:1639207558
Name:UROLOGY ASSOCIATES OF WILLIAMSON COUNTY
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES OF WILLIAMSON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:NEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-244-0161
Mailing Address - Street 1:4112 LINKS LANE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664
Mailing Address - Country:US
Mailing Address - Phone:512-244-0161
Mailing Address - Fax:512-244-7814
Practice Address - Street 1:4112 LINKS LANE
Practice Address - Street 2:SUITE 103
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-244-0161
Practice Address - Fax:512-244-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6896208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121701002Medicaid
TX121701002Medicaid