Organization
JORGE R BROTHERS M D P A
Active
Other names
Advanced Urology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE R BROTHERS M.D. (OWNER)
(806) 771-5882
Entity
Organization
Contact information
Practice address
418 N UTICA AVE, LUBBOCK, TX 79416-3035
(806) 771-5882
(806) 687-9002
Mailing address
418 N UTICA AVE, LUBBOCK, TX 79416-3035
(806) 771-5882
(806) 687-9002
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H1048
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010PC
BLUE CROSS BLUE SHOIELD TEXAS
TX
05
—
10658823
—
NM
05
—
186542001
—
TX
Enumeration date
11/06/2006
Last updated
05/07/2012
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