MEDICARE: MAINLAND UROLOGY CLINIC PA

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	208800000X	Urology Physician	J1130	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881743516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAINLAND UROLOGY CLINIC PA

Provider Business Mailing Address
First Line	:	313 FM 517 RD W
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-4009
Country	:	US
Telephone Number	:	281-967-7912
Fax Number	:	281-967-7915

Provider Business Practice Location Address
First Line	:	313 FM 517 RD W
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-4009
Country	:	US
Telephone Number	:	281-967-7912
Fax Number	:	281-967-7915

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MATTHEW MILES ROBINSON
Credential	:	M.D.
Telephone Number	:	281-967-7912

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	09/25/2014

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Practice Location Address:

313 FM 517 RD W
DICKINSON, TX
77539-4009

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1124021860 — PAMELA B ROBINSON M.D.
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77539-4009

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1912989369 — DR. MATTHEW MILES ROBINSON M.D.
Practice Location Address:

313 FM 517 RD W
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77539-4009

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1366652828 — MAINLAND EYE CLINIC PA
Practice Location Address:

313 FM 517 RD WEST
DICKINSON, TX
77539-4009

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1053030528 — BRIONNE A JENKINS
Practice Location Address:

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1316942337 — DR. JOHN RAYMOND CHACONAS D.D.S.
Practice Location Address:

914 FM 517 RD W STE 204
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Directions to “MAINLAND UROLOGY CLINIC PA ” Practice Location

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