# NORTHERN NEVADA LITHOTRIPSY

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

## Provider details

- **NPI number:** 1982822615
- **Authorized official:** LATANYA CASTILE (PAYER RELATIONS)
- **Authorized official phone:** (847) 544-5939

## Contact information

- **Practice address:** 1990 STEAM WAY STE A102, ROUND ROCK, TX 78665-2233
- **Practice address phone:** (877) 465-4845
- **Practice address fax:** (512) 872-5105
- **Mailing address:** 1990 STEAM WAY STE A102, ROUND ROCK, TX 78665-2233
- **Mailing address phone:** (877) 465-4845
- **Mailing address fax:** (512) 872-5105

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | — |
| 208800000X | Urology Physician | — | — | — |
| 261QL0400X | Lithotripsy Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/20/2007
- **Last updated:** 07/01/2024