Provider Demographics
NPI:1215472600
Name:UROLOGY AUSTIN PHARMACY LLC
Entity type:Organization
Organization Name:UROLOGY AUSTIN PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:BISCHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-410-3770
Mailing Address - Street 1:8701 N MOPAC EXPY STE 375
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8376
Mailing Address - Country:US
Mailing Address - Phone:512-410-3770
Mailing Address - Fax:512-410-3780
Practice Address - Street 1:8701 N MOPAC EXPY STE 375
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8376
Practice Address - Country:US
Practice Address - Phone:512-410-3770
Practice Address - Fax:512-410-3780
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UROLOGY AUSTIN PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-21
Last Update Date:2024-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31136333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy