Healthcare Provider Details

I. General information

NPI: 1154828853
Provider Name (Legal Business Name): LAPLATA UROLOGICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E 3RD AVE STE 103
DURANGO CO
81301-5046
US

IV. Provider business mailing address

1800 E 3RD AVE STE 103
DURANGO CO
81301-5046
US

V. Phone/Fax

Practice location:
  • Phone: 970-264-2224
  • Fax:
Mailing address:
  • Phone: 970-264-2224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number46127
License Number StateCO

VIII. Authorized Official

Name: ASHLEY BEAVER
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 406-927-2988