Provider Demographics
NPI:1265499578
Name:ROBERT E URREA MD PA
Entity type:Organization
Organization Name:ROBERT E URREA MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-881-8264
Mailing Address - Street 1:6211 EDGEMERE BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925
Mailing Address - Country:US
Mailing Address - Phone:915-881-8264
Mailing Address - Fax:915-881-8082
Practice Address - Street 1:6211 EDGEMERE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925
Practice Address - Country:US
Practice Address - Phone:915-881-8264
Practice Address - Fax:915-881-8082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0067MWOtherBCBS
TX5382750001Medicare NSC
00179YMedicare ID - Type Unspecified
G52895Medicare UPIN