NPIMap

Organization Active NPI

Ark la Tex Urology & Prostate Cancer Institute, a Professional Medical

  • Urology Physician
  • Bossier City, LA
National Provider Identifier
1679615207
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
020454 Issued in LA
Legal business name
ARK LA TEX UROLOGY & PROSTATE CANCER INSTITUTE, A PROFESSIONAL MEDICAL
Practice address
2300 Hospital Dr
Suite 400
Bossier City, LA 71111-2394
Phone
(318) 841-4004
NPI assigned
Feb 12, 2007
Last updated
Sep 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
William Stewart Bundrick Jr., M.D.NPI 1326087354
Title
Owner
Phone
(318) 841-4004

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 020454 LA Primary

Addresses

Primary practice location

2300 Hospital Dr
Suite 400
Bossier City, LA 71111-2394

Mailing address

2300 Hospital Dr
Suite 400
Bossier City, LA 71111-2394
Phone (318) 841-4004

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1679615207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 400",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-841-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HOSPITAL DR",
            "address_2": "SUITE 400",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711112394",
            "telephone_number": "318-841-4004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARK LA TEX UROLOGY & PROSTATE CANCER INSTITUTE, A PROFESSIONAL MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "BUNDRICK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-841-4004",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "020454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.