Healthcare Provider Details

I. General information

NPI: 1649215039
Provider Name (Legal Business Name): HOUSTON UROLOGIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6560 FANNIN ST SUITE 1270
HOUSTON TX
77030-2761
US

IV. Provider business mailing address

6560 FANNIN ST SUITE 1270
HOUSTON TX
77030-2761
US

V. Phone/Fax

Practice location:
  • Phone: 713-790-9779
  • Fax: 713-794-0719
Mailing address:
  • Phone: 713-790-9779
  • Fax: 713-794-0719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN C POWERS
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 713-790-9779