MEDICARE: AMERICAN INSTITUTE FOR UNRINARY INCONTINENCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	K9806	TX

General Provider Information

NPI Number	:	1417282609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN INSTITUTE FOR UNRINARY INCONTINENCE

Provider Business Mailing Address
First Line	:	12800 PRESTON RD
Second Line	:	STE 201
City	:	DALLAS
State	:	TX
Zip	:	75230-1365
Country	:	US
Telephone Number	:	972-458-2484
Fax Number	:

Provider Business Practice Location Address
First Line	:	12800 PRESTON RD
Second Line	:	STE 201
City	:	DALLAS
State	:	TX
Zip	:	75230-1365
Country	:	US
Telephone Number	:	972-458-2484
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ERWIN CRUZ
Credential	:	M.D.
Telephone Number	:	972-458-2484

Provider Enumeration Date	:	10/06/2009
Last Update Date	:	10/08/2009

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