Organization Active NPI

Urology Clinics of North Texas, PLLC

  • Urology Physician
  • Augusta, GA
National Provider Identifier
1063879005
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
UROLOGY CLINICS OF NORTH TEXAS, PLLC
Practice address
971 Broad St
#3
Augusta, GA 30901-7225
Phone
(706) 434-2600
Fax
(706) 434-2639
NPI assigned
Jan 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jerri D Wilson
Title
Ceo
Phone
(214) 691-1902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

971 Broad St
#3
Augusta, GA 30901-7225

Mailing address

7515 Greenville Ave
Suite 900
Dallas, TX 75231-3831
Phone (214) 691-1902

National Provider Directory

National Provider Directory

Locations

971 Broad St
#3
Augusta, GA 30901
Phone (706) 434-2600

1650 Republic Pkwy
Ste 150
Mesquite, TX 75150
Phone (214) 692-8262

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1063879005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7515 GREENVILLE AVE",
            "address_2": "SUITE 900",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752313831",
            "telephone_number": "214-691-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 BROAD ST",
            "address_2": "#3",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309017225",
            "telephone_number": "706-434-2600",
            "fax_number": "706-434-2639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY CLINICS OF NORTH TEXAS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-21",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JERRI",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-691-1902"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.