Provider Demographics
NPI:1669340543
Name:RIVERSTONE UROLOGY SPECIALISTS PLLC
Entity type:Organization
Organization Name:RIVERSTONE UROLOGY SPECIALISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:LIBBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-909-5591
Mailing Address - Street 1:506 HUNTERS PARK LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-5411
Mailing Address - Country:US
Mailing Address - Phone:404-909-5591
Mailing Address - Fax:
Practice Address - Street 1:24518 NORTHWEST FWY
Practice Address - Street 2:MEDICAL OFFICE BUILDING 2, SUITE 445
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2904
Practice Address - Country:US
Practice Address - Phone:404-909-5591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty