Provider Demographics
NPI:1760490353
Name:UROLOGY ASSOCIATES OF KERRVILLE
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES OF KERRVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FRITZSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-257-7533
Mailing Address - Street 1:251 CULLY DR STE C
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6084
Mailing Address - Country:US
Mailing Address - Phone:830-257-7533
Mailing Address - Fax:830-896-4151
Practice Address - Street 1:251 CULLY DR STE C
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6084
Practice Address - Country:US
Practice Address - Phone:830-257-7533
Practice Address - Fax:830-896-4151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7326208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0809121-01Medicaid
TX0809121-01Medicaid