# GREATER AUSTIN UROLOGY, PLLC

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

## Provider details

- **NPI number:** 1215443064
- **Authorized official:** LUCAS JACOMIDES MD (OWNER/PRINCIPAL)
- **Authorized official phone:** (512) 540-3937

## Contact information

- **Practice address:** 11673 JOLLYVILLE RD STE B101, AUSTIN, TX 78759
- **Practice address phone:** (512) 540-3937
- **Mailing address:** 17220 CRESCENT HEIGHTS TRL, AUSTIN, TX 78717-2962

## Taxonomy

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

## Other

- **Enumeration date:** 12/15/2017
- **Last updated:** 05/29/2018