# ADVANCED UROLOGY OF EL PASO, P.A

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194966309
- **Authorized official:** DR. MAURICIO DAVALOS M.D. (OWNER)
- **Authorized official phone:** (914) 909-6565

## Contact information

- **Practice address:** 10301 GATEWAY BLVD W, SUITE 300, EL PASO, TX 79925-3315
- **Practice address phone:** (915) 779-1716
- **Mailing address:** 10301 GATEWAY BLVD W, SUITE 300, EL PASO, TX 79925-7701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/18/2009
- **Last updated:** 03/18/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | N1606 | MEDICAL LICENSE | TX |