UROLOGY CLINICS OF NORTH TEXAS PLLC
Urology at Kestrel Dr, Collegeville, PA

License number
Pennsylvania M0918
Category
Radiology
Type
Urology
Owner
Name: JERRI D WILSON
Title: CEO
Phone: (214) 691-1902
Address
Address 2
100 Kestrel Dr, Collegeville, PA 19426
7515 Greenville Ave SUITE 900, Dallas, TX 75231
National Provider ID: 1659621035
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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UROLOGY CLINICS OF NORTH TEXAS, PLLC

7515 Greenville Ave STE 900, Dallas, TX 75231

Registration:
Dec 29, 2011
State ID:
0801527091
Business type:
Domestic Limited Liability Company (LLC)
Members:
Aimee D Carr (Member), 7515 Greenville Ave SUITE 900, Dallas, TX 75231,Meredith L Lightfoot (Member), 7515 Greenville Ave SUITE 900, Dallas, TX 75231,Lon M. Goldstein (Member),...
Agent:
Jerri D Wilson,7515 Greenville Ave, Dallas, TX 75231 (Physical)
TIN:
32036002973

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