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General NPI Number Information
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NPI Number | 1104932391
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Entity Type | Organization
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Legal Business Name | BROWNSVILLE UROLOGICAL ASSOCIATES
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 864 CENTRAL BLVD # 500
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City | BROWNSVILLE
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State | TX
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Zip | 78520
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Country | US
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Telephone | 956-546-3595
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Fax | 956-541-9849
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Provider Business Mailing Address
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Address Line | 864 CENTRAL BLVD # 500
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City | BROWNSVILLE
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State | TX
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Zip | 78520
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Country | US
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Telephone | 956-546-3595
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Fax | 956-541-9849
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JOSE L VILLALOBOS
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Credential | MD
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Telephone | 956-546-3595
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | D9700
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License Number State | TX
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