Haddad Urology Clinic, P.a.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

F8503 Issued in TX

Legal business name

HADDAD UROLOGY CLINIC, P.A.

Practice address

1501 W 11TH PL
Suite103
Big Spring, TX 79720-4119

Phone

(432) 714-4600

Fax

(432) 714-4604

NPI assigned

Oct 13, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Rudy I Haddad, MD

Title

Principal Officer

Phone

(432) 714-4600

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1609865534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W 11TH PL",
            "address_2": "SUITE103",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797204119",
            "telephone_number": "432-714-4600",
            "fax_number": "432-714-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W 11TH PL",
            "address_2": "SUITE103",
            "city": "BIG SPRING",
            "state": "TX",
            "postal_code": "797204119",
            "telephone_number": "432-714-4600",
            "fax_number": "432-714-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HADDAD UROLOGY CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-13",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "RUDY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRINCIPAL OFFICER",
        "authorized_official_telephone_number": "432-714-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "TX",
            "license": "F8503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "160460501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "0072JY",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jasmine Grosse
• Guardian Enterprise LLC (Guardian Mobility)
• Kelsie Marie Guinn, SLP
• Deborah Gullatt, LPC
• H-E-B, LP (HEB Pharmacy #051)
• Rudy I Haddad, MD
• Ba Han, M.D.
• Misti K Harland
• Sharron Harrell
• Laurie Wooten Harris

• Urology Physician in Big Spring, TX
• Providers in Big Spring, TX by specialty
• Urology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; 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.