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General NPI Number Information
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NPI Number | 1306057732
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Entity Type | Individual
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Provider Name | RICHARD A URBINA DO
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Gender | Male
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 7950 W JEFFERSON BLVD
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City | FORT WAYNE
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State | IN
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Zip | 46804-4140
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Country | US
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Telephone | 260-435-2699
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 847522
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City | DALLAS
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State | TX
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Zip | 75284-7522
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Country | US
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Telephone | 903-531-5000
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 02007508A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101016000
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | P2388
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0102202607
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License Number State | VA
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