Urology Center of East Texas, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

UROLOGY CENTER OF EAST TEXAS, P.A.

Practice address

1701 South Palestine
Suite a
Athens, TX 75751-5739

Phone

(903) 675-9339

Fax

(903) 675-9344

NPI assigned

Aug 7, 2006

Last updated

Apr 15, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Juanice Burton

Title

Administrative Assistant

Phone

(903) 675-9339

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429056000000",
    "number": "1720097694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 SOUTH PALESTINE",
            "address_2": "SUITE A",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757515739",
            "telephone_number": "903-675-9339",
            "fax_number": "903-675-9344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SOUTH PALESTINE",
            "address_2": "SUITE A",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757515739",
            "telephone_number": "903-675-9339",
            "fax_number": "903-675-9344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY CENTER OF EAST TEXAS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2015-04-15",
        "status": "A",
        "authorized_official_last_name": "BURTON",
        "authorized_official_first_name": "JUANICE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "903-675-9339",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0806614-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00901R",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Athens, TX
• Providers in Athens, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.