Active NPI
Urology Assoc of San Antonio PA
- Urology Physician
- San Antonio, TX
National Provider Identifier
1801990486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- UROLOGY ASSOC OF SAN ANTONIO PA
- Practice address
- 1303 McCullough Ave
Suite 561
San Antonio, TX 78212-5668 - Phone
- (210) 227-9376
- Fax
- (210) 227-0916
- NPI assigned
- Sep 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Jerry Elliot Kruse, MD
- Title
- President
- Phone
- (210) 227-9376
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | Primary |
Addresses
Primary practice location
1303 McCullough Ave
Suite 561
San Antonio, TX 78212-5668
Mailing address
1303 McCullough Ave
Suite 561
San Antonio, TX 78212-5668
Phone (210) 227-9376
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 083200801 | Medicaid | TX | |
| CP8906 | Other | TX | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryLocations
1303 McCullough Ave
Ste 561
San Antonio, TX 78212
Phone (210) 227-9376
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158019200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1278374400000",
"number": "1801990486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1303 MCCULLOUGH AVE",
"address_2": "SUITE 561",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782125668",
"telephone_number": "210-227-9376",
"fax_number": "210-227-0916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1303 MCCULLOUGH AVE",
"address_2": "SUITE 561",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782125668",
"telephone_number": "210-227-9376",
"fax_number": "210-227-0916"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UROLOGY ASSOC OF SAN ANTONIO PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-12",
"last_updated": "2010-07-06",
"status": "A",
"authorized_official_last_name": "KRUSE",
"authorized_official_first_name": "JERRY",
"authorized_official_middle_name": "ELLIOT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "210-227-9376",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "083200801",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CP8906",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.