Provider Demographics
NPI:1740283522
Name:SOUTH TEXAS UROLOGY & UROLOGIC ONCOLOGY, P.A.
Entity type:Organization
Organization Name:SOUTH TEXAS UROLOGY & UROLOGIC ONCOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:SAROSDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-615-3899
Mailing Address - Street 1:9102 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1553
Mailing Address - Country:US
Mailing Address - Phone:210-615-3899
Mailing Address - Fax:210-615-3803
Practice Address - Street 1:9102 FLOYD CURL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1553
Practice Address - Country:US
Practice Address - Phone:210-615-3899
Practice Address - Fax:210-615-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6102208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095052902Medicaid
TX0049BYMedicare ID - Type Unspecified