Provider Demographics
NPI:1952432437
Name:RENE P GRABATO MD PA
Entity Type:Organization
Organization Name:RENE P GRABATO MD PA
Other - Org Name:THE UROLOGY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:P
Authorized Official - Last Name:GRABATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-665-6511
Mailing Address - Street 1:2931 PERRYTON PKWY
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-2823
Mailing Address - Country:US
Mailing Address - Phone:806-665-6511
Mailing Address - Fax:806-665-3717
Practice Address - Street 1:2931 PERRYTON PKWY
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-2823
Practice Address - Country:US
Practice Address - Phone:806-665-6511
Practice Address - Fax:806-665-3717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1035208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098179702Medicaid
TX098179702Medicaid
TXB23105Medicare UPIN