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Organization
ADVANCED UROLOGY OF EL PASO, P.A
Active
Organization
ADVANCED UROLOGY OF EL PASO, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICIO DAVALOS M.D. (OWNER)
(914) 909-6565
Entity
Organization
Contact information
Practice address
10301 GATEWAY BLVD W, SUITE 300, EL PASO, TX 79925-3315
(915) 779-1716
Mailing address
10301 GATEWAY BLVD W, SUITE 300, EL PASO, TX 79925-7701
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N1606
MEDICAL LICENSE
TX
Enumeration date
03/18/2009
Last updated
03/18/2009
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