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
6124 W PARKER RD, SUITE 434, PLANO, TX 75093-8122
(214) 691-1902
(214) 987-1845
Mailing address
1650 REPUBLIC PKWY STE 120, MESQUITE, TX 75150-6920
(214) 692-8262
(214) 696-4190
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
—
—
2085R0001X
Radiation Oncology Physician
K3232
TX
208800000X
Urology Physician
Primary
M0918
TX
2088P0231X
Pediatric Urology Physician
G9345
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036DE
BCBS GROUP
TX
05
—
1114186616
—
TX
01
—
CI6341
RRMCR GROUP
TX
01
—
CI6342
RRMCR GROUP
TX
Enumeration date
06/09/2008
Last updated
12/18/2025
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