Southside Urology Clinic, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

3478 Issued in OK

Legal business name

SOUTHSIDE UROLOGY CLINIC, P.C.

Practice address

9817 S Western Ave
Oklahoma City, OK 73139-2812

Phone

(405) 632-4500

Fax

(405) 632-7500

NPI assigned

Feb 27, 2008

Organization subpart

No

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

Authorized official

Name

Rajendra K Motwani, D.O.

Title

Owner

Phone

(405) 632-4500

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469404800000",
    "number": "1629247341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9817 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392812",
            "telephone_number": "405-632-4500",
            "fax_number": "405-632-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9817 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731392812",
            "telephone_number": "405-632-4500",
            "fax_number": "405-632-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE UROLOGY CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2016-07-25",
        "status": "A",
        "authorized_official_last_name": "MOTWANI",
        "authorized_official_first_name": "RAJENDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-632-4500",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OK",
            "license": "3478",
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OK",
            "license": "3478",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200620340A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southerncare, Inc
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• Southpointe Family Dentistry PLLC Dba Westmoore Family Dentistry
• Southridge Dental Arts PLLC
• Southside Urology Clinic, P.C.
• Susie I Southwell, MED
• Southwest Ambulatory Surgery Center, LLC
• Southwest Anesthesia Services, LLC
• Southwest Cardiology Associates, Inc.

• Specialist in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.