Provider Demographics
NPI:1457599334
Name:THE UROLOGY INSTITUTE FRSICO
Entity Type:Organization
Organization Name:THE UROLOGY INSTITUTE FRSICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SIFERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-343-7990
Mailing Address - Street 1:4401 COIT RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0500
Mailing Address - Country:US
Mailing Address - Phone:469-633-0095
Mailing Address - Fax:469-633-0096
Practice Address - Street 1:9 MEDICAL PKWY STE 307
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7855
Practice Address - Country:US
Practice Address - Phone:972-243-3368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5889208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00059TMedicare UPIN