Healthcare Provider Details
I. General information
NPI: 1760490353
Provider Name (Legal Business Name): UROLOGY ASSOCIATES OF KERRVILLE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2006
Last Update Date: 07/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
251 CULLY DR STE C
KERRVILLE TX
78028-6084
US
IV. Provider business mailing address
251 CULLY DR STE C
KERRVILLE TX
78028-6084
US
V. Phone/Fax
- Phone: 830-257-7533
- Fax: 830-896-4151
- Phone: 830-257-7533
- Fax: 830-896-4151
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | J7326 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
RALPH
JAMES
FRITZSCH
Title or Position: OWNER
Credential: M.D.
Phone: 830-257-7533