Provider Demographics
NPI:1639885304
Name:AZ FEMALE UROLOGIST, LLC
Entity Type:Organization
Organization Name:AZ FEMALE UROLOGIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YASMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-726-4416
Mailing Address - Street 1:10617 N HAYDEN RD STE B-102
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10617 N HAYDEN RD STE B-102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5685
Practice Address - Country:US
Practice Address - Phone:480-483-9011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1922284579OtherNPI