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General NPI Number Information
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NPI Number | 1912916131
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Entity Type | Organization
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Legal Business Name | RENAISSANCE UROLOGY CENTERS PA
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 06/10/2015
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Provider Practice Location Address
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Address Line | 2717 CORNERSTONE BLVD
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City | EDINBURG
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State | TX
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Zip | 78539-8464
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Country | US
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Telephone | 956-683-7342
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Fax | 953-683-0957
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Provider Business Mailing Address
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Address Line | PO BOX 720657
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City | MCALLEN
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State | TX
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Zip | 78504-0657
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Country | US
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Telephone | 956-683-7342
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Fax | 956-683-0957
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL Y SEIBA
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Credential | MD
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Telephone | 956-683-7342
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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 |
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License Number State |
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