Organization
UROLOGY CLINICS OF NORTH TEXAS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRI D WILSON (CEO)
(214) 691-1902
Entity
Organization
Contact information
Practice address
971 BROAD ST, #3, AUGUSTA, GA 30901-7225
(706) 434-2600
(706) 434-2639
Mailing address
7515 GREENVILLE AVE, SUITE 900, DALLAS, TX 75231-3831
(214) 691-1902
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
01/21/2016
Last updated
01/21/2016
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