Provider Demographics
NPI:1174801831
Name:PRECISION UROLOGY ASSOCIATES, PA
Entity type:Organization
Organization Name:PRECISION UROLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-548-7713
Mailing Address - Street 1:8811 FM 1960 BYPASS RD W
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3951
Mailing Address - Country:US
Mailing Address - Phone:281-548-7713
Mailing Address - Fax:281-548-1414
Practice Address - Street 1:8811 FM 1960 BYPASS RD W
Practice Address - Street 2:SUITE 300
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3951
Practice Address - Country:US
Practice Address - Phone:281-548-7713
Practice Address - Fax:281-548-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB135284Medicare PIN