Organization
BAYSIDE UROLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENNY MORA (BILING & COLLECTIONS MANAGER)
(361) 881-9550
Entity
Organization
Contact information
Practice address
2222 MORGAN AVE, STE. #112, CORPUS CHRISTI, TX 78405-1948
(361) 881-9550
(361) 881-8337
Mailing address
PO BOX 2848, CORPUS CHRISTI, TX 78403-2848
(361) 881-9550
(361) 881-8337
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J3782
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008176005
CIGNA
TX
01
—
0024CK
BLUE CROSS BLUE SHIELD
TX
05
—
079579101
—
TX
05
—
099538301
—
TX
01
—
1533350
UNITED MINE WORKERS
TX
01
—
1900172
UNITED HEALTHCARE
TX
01
—
340014366
RAILROAD MEDICARE
TX
01
—
5955010
AETNA
TX
01
—
855163
FIRST HEALTH
TX
01
—
P1619681
OXFORD
TX
Enumeration date
04/25/2007
Last updated
02/19/2016
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