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Organization
UROLOGY CLINICS OF NORTH TEXAS
Active
Organization
UROLOGY CLINICS OF NORTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRI D WILSON (CEO)
(214) 691-1902
Entity
Organization
Contact information
Practice address
1600 W COLLEGE ST, SUITE 140, GRAPEVINE, TX 76051-3580
(214) 826-6051
Mailing address
7515 GREENVILLE AVE, SUITE 900, DALLAS, TX 75231-3831
(214) 691-1902
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
193400000X
TX
208800000X
Urology Physician
Primary
193400000X
TX
Other
Enumeration date
04/19/2011
Last updated
04/19/2011
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