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General NPI Number Information
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NPI Number | 1053357871
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Entity Type | Individual
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Provider Name | JOSE A URQUIDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 11851 JOLLYVILLE RD STE 103
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City | AUSTIN
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State | TX
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Zip | 78759-2350
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Country | US
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Telephone | 512-541-2591
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Fax |
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Provider Business Mailing Address
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Address Line | 11851 JOLLYVILLE RD STE 103
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City | AUSTIN
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State | TX
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Zip | 78759-2350
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Country | US
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Telephone | 512-541-2591
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | L9942
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | L9942
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License Number State | TX
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