# UROLOGY ASC- PHOENIX, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Urologic Surgery Center of Arizona
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275198673
- **Authorized official:** ERIC BOON (OFFICER/AUTHORIZED OFFICIAL)
- **Authorized official phone:** (480) 567-0269

## Contact information

- **Practice address:** 1313 E OSBORN RD STE 170B, PHOENIX, AZ 85014-5678
- **Practice address phone:** (602) 264-4431
- **Practice address fax:** (602) 266-3870
- **Mailing address:** 14201 DALLAS PKWY, DALLAS, TX 75254-2916
- **Mailing address phone:** (469) 872-4706

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/01/2019
- **Last updated:** 10/24/2024