Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PE0004X | Emergency Medical Services | L9942 | TX |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | L9942 | TX |
NPI | 1053357871 |
---|---|
Provider Name | Dr. Jose A Urquidez |
First Address | Austin, TX 78759-2350 |
Second Address | Austin, TX 78759-2350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 17/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
170229202 | (05) | TX |
8BK240 | BCBS OF TEXAS (01) | TX |
I23328 | (02) | TX |