NPIMap

Organization Active NPI

Jorge R Brothers M D P a

  • Specialist
  • Lubbock, TX
National Provider Identifier
1457420515
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
H1048 Issued in TX
Legal business name
JORGE R BROTHERS M D P A
Practice address
418 N Utica Ave
Lubbock, TX 79416-3035
Phone
(806) 771-5882
Fax
(806) 687-9002
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Authorized official

Name
Jorge R Brothers, M.D.
Title
Owner
Phone
(806) 771-5882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X H1048 TX Primary

Addresses

Primary practice location

418 N Utica Ave
Lubbock, TX 79416-3035

Mailing address

418 N Utica Ave
Lubbock, TX 79416-3035
Phone (806) 771-5882

Other identifiers 3

IdentifierTypeStateIssuer
10658823MedicaidNM
0010PCOtherTXBLUE CROSS BLUE SHOIELD TEXAS
186542001MedicaidTX

Other names 1

  • Advanced Urology Associates Doing business as

National Provider Directory

National Provider Directory

Locations

418 N Utica Ave
Lubbock, TX 79416
Phone (806) 771-5882

3805 22nd St
Ste A
Lubbock, TX 79410
Phone (806) 771-5882

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336348800000",
    "number": "1457420515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 N UTICA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163035",
            "telephone_number": "806-771-5882",
            "fax_number": "806-687-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 N UTICA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794163035",
            "telephone_number": "806-771-5882",
            "fax_number": "806-687-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORGE R BROTHERS M D P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2012-05-07",
        "status": "A",
        "authorized_official_last_name": "BROTHERS",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-771-5882",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "H1048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10658823",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHOIELD TEXAS",
            "identifier": "0010PC",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186542001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Urology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2012; 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.