Organization
BROWNWOOD UROLOGICAL ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRESCENT L CLARK (BILLING)
(325) 643-2000
Entity
Organization
Contact information
Practice address
100 MILLER DR, BROWNWOOD, TX 76801-5947
(325) 643-2000
(325) 643-2099
Mailing address
100 MILLER DR, BROWNWOOD, TX 76801-5947
(325) 643-2000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093NT
BLUE CROSS
TX
05
—
182555601
—
TX
Enumeration date
07/01/2006
Last updated
11/04/2009
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