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Organization

URODEL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHAMOON DOCTOR M.D. (OWNER)
(830) 775-3025
Entity
Organization

Contact information

Practice address
305 E GARFIELD ST, DEL RIO, TX 78840-5109
(830) 775-3025
(830) 768-4831
Mailing address
305 E GARFIELD ST, DEL RIO, TX 78840-5109
(830) 775-3025
(830) 768-4831

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
F2437
TX
208800000X
Urology Physician
Primary
F2437
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
$$$$$$$$$
SOCIAL SECURITY NUMBER
TX
05
150283302
TX
05
163208501
TX
01
F2437
LICENSE
TX
Enumeration date
03/21/2007
Last updated
05/21/2020
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