1922280114 NPI number — THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922280114 NPI number — THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
UT HOUSTON ENDODONTICS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922280114
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7500 CAMBRIDGE SUITE 6400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-486-4112
Provider Business Mailing Address Fax Number:
713-486-0402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7500 CAMBRIDGE SUITE 1462
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-486-4230
Provider Business Practice Location Address Fax Number:
713-486-0845
Provider Enumeration Date:
11/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KIRKPATRICK
Authorized Official First Name:
TIMOTHY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIR, PROFESSOR, ADV EDU PROG DIR
Authorized Official Telephone Number:
713-486-4227

Provider Taxonomy Codes

  • Taxonomy code: 1223E0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009886501 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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