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Organization
GREATER AUSTIN UROLOGY, PLLC
Active
Organization
GREATER AUSTIN UROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCAS JACOMIDES MD (OWNER/PRINCIPAL)
(512) 540-3937
Entity
Organization
Contact information
Practice address
11673 JOLLYVILLE RD STE B101, AUSTIN, TX 78759
(512) 540-3937
Mailing address
17220 CRESCENT HEIGHTS TRL, AUSTIN, TX 78717-2962
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
NULL
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
12/15/2017
Last updated
05/29/2018
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