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
100 KESTREL DR, COLLEGEVILLE, PA 19426-2060
(610) 831-5354
(214) 853-9415
Mailing address
7515 GREENVILLE AVE, SUITE 900, DALLAS, TX 75231-3831
(214) 691-1902
(214) 853-9415
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
M0918
TX
Other
Enumeration date
09/13/2012
Last updated
11/07/2012
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