Provider Demographics
NPI:1013093780
Name:METROPOLITAN UROLOGICAL SPECIALISTS
Entity Type:Organization
Organization Name:METROPOLITAN UROLOGICAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-645-6454
Mailing Address - Street 1:630 EMERSON RD
Mailing Address - Street 2:LOFT 404
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6745
Mailing Address - Country:US
Mailing Address - Phone:314-995-9782
Mailing Address - Fax:
Practice Address - Street 1:11710 ADMINISTRATION DR
Practice Address - Street 2:SUITE # 22
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3407
Practice Address - Country:US
Practice Address - Phone:314-645-6454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty