Provider Demographics
NPI:1013749670
Name:UROLOGEX LLC
Entity type:Organization
Organization Name:UROLOGEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ORTIZ-AVALOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-265-8342
Mailing Address - Street 1:196 DIEGO LOOP RD
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-2463
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:114 W LOSOYA ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-5858
Practice Address - Country:US
Practice Address - Phone:830-488-6020
Practice Address - Fax:830-488-6030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty