Spring Creek Urology Specialists LLC

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

J6530 Issued in TX

Legal business name

SPRING CREEK UROLOGY SPECIALISTS LLC

Practice address

506 Medical Center Blvd
Suite 304
Conroe, TX 77304-2942

Phone

(855) 259-2872

Fax

(888) 815-6161

NPI assigned

Jan 30, 2012

Organization subpart

No

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

Authorized official

Name

Ajay KwatraNPI 1215024195

Title

Owner

Phone

(855) 259-2872

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ajay Kwatra, MD

  • Urology Physician
  • Conroe, TX
  • NPI 1215024195
  Medicare reassignment NPD Authorized official
• Candice Clark, FNP-C

  • Family Nurse Practitioner
  • Houston, TX
  • NPI 1760932537
  Medicare reassignment NPD
• Kudzwai Mutanga

  • Family Nurse Practitioner
  • Conroe, TX
  • NPI 1932947918
  Medicare reassignment NPD
• Samir Pradeep Shirodkar, MD

  • Urology Physician
  • The Woodlands, TX
  • NPI 1679774459
  Medicare reassignment NPD
• Erwin Charles Winkel III, MD

  • Urology Physician
  • Houston, TX
  • NPI 1093874331
  Medicare reassignment NPD
• Jason Ertan Berilgen, MD

  • Radiation Oncology Physician
  • The Woodlands, TX
  • NPI 1972707578
  Medicare reassignment
• Maria Guadalupe Navarro Elias, PA-C

  • Physician Assistant
  • Coldspring, TX
  • NPI 1518745066
  Medicare reassignment
• Hilton Wong Yee, MD

  • Plastic Surgery Physician
  • The Woodlands, TX
  • NPI 1457449191
  NPD
• Syed M Zaidi, M.D.

  • Nephrology Physician
  • Conroe, TX
  • NPI 1912090572
  NPD (past)

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1386916989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4346",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104346",
            "telephone_number": "855-259-2872",
            "fax_number": "888-815-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 MEDICAL CENTER BLVD",
            "address_2": "SUITE 304",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042942",
            "telephone_number": "855-259-2872",
            "fax_number": "888-815-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRING CREEK UROLOGY SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "KWATRA",
        "authorized_official_first_name": "AJAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "855-259-2872"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "TX",
            "license": "J6530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303906701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Speech Boulevard, LLC
• Stephanie Spencer, FNP-C
• Jennifer Leigh Spillman, PSYD
• Spine Wellness Centers
• Spring Anesthesia PLLC
• Kayla Brianne Springer
• Katherine Sralla, M.S. CCC-SLP
• Siddarth Srikumar
• SS Surgical Assisting, LLC
• Sspmr, PLLC (Sandstone Family Medicine)

• Urology Physician in Conroe, TX
• Providers in Conroe, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.