Organization
ADVANCED UROLOGY OF EL PASO, P.A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICIO DAVALOS M.D. (OWNER)
(914) 909-6565
Entity
Organization
Contact information
Practice address
10301 GATEWAY BLVD W, SUITE 300, EL PASO, TX 79925-3315
(915) 779-1716
Mailing address
10301 GATEWAY BLVD W, SUITE 300, EL PASO, TX 79925-7701
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N1606
MEDICAL LICENSE
TX
Enumeration date
03/18/2009
Last updated
03/18/2009
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