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Urology Associates Of Texarkana, PA

Specialist in Texarkana, TX. Organization (NPI-2).

NPI number1083665327
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1083665327
Entity type
Organization (NPI-2)
Legal business name
Urology Associates Of Texarkana, PA
Organization subpart
No
Enumeration date
May 12, 2006
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist––Yes

Practice location

1902 Moores Ln
Texarkana, TX 75503-4610

Phone 903-792-7515 · Fax 903-793-8225

Mailing address

1902 Moores Ln
Texarkana, TX 75503-4610

Phone 903-792-7515 · Fax 903-793-8225

Authorized official

Vongphanet Joe Siharath
Administrator
9037927515

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