# UROLOGY TYLER, PA

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

## Provider details

- **NPI number:** 1861572968
- **Authorized official:** DR. STANTON P. CHAMPION MD (PRESIDENT)
- **Authorized official phone:** (903) 262-3900

## Contact information

- **Practice address:** 700 OLYMPIC PLAZA CIR STE 700, TYLER, TX 75701-1954
- **Practice address phone:** (903) 262-3900
- **Practice address fax:** (903) 262-3993
- **Mailing address:** PO BOX 8026, TYLER, TX 75711-8026
- **Mailing address phone:** (903) 262-3900
- **Mailing address fax:** (903) 262-3993

## Taxonomy

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

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 08/14/2013