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General NPI Number Information
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NPI Number | 1881743516
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Entity Type | Organization
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Legal Business Name | MAINLAND UROLOGY CLINIC PA
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 09/25/2014
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Provider Practice Location Address
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Address Line | 313 FM 517 RD W
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City | DICKINSON
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State | TX
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Zip | 77539-4009
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Country | US
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Telephone | 281-967-7912
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Fax | 281-967-7915
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Provider Business Mailing Address
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Address Line | 313 FM 517 RD W
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City | DICKINSON
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State | TX
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Zip | 77539-4009
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Country | US
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Telephone | 281-967-7912
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Fax | 281-967-7915
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MATTHEW MILES ROBINSON
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Credential | M.D.
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Telephone | 281-967-7912
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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 | J1130
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License Number State | TX
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