1720362502 NPI number — UT SOUTHWESTERN MEDICAL CENTER

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 1720362502 NPI number — UT SOUTHWESTERN MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UT SOUTHWESTERN MEDICAL CENTER
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:
Provider Other Organization Name Type Code:
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:
1720362502
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5161 HARRY HINES BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75235-7707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-648-7850
Provider Business Mailing Address Fax Number:
214-648-2204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5303 HARRY HINES BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75390-8855
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-645-2300
Provider Business Practice Location Address Fax Number:
214-645-2301
Provider Enumeration Date:
09/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
SAMSON
Authorized Official First Name:
DUKE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN, NEUROSURGERY
Authorized Official Telephone Number:
214-648-6727

Provider Taxonomy Codes

  • Taxonomy code: 275N00000X , with the licence number:  589350 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA1903X , with the licence number: 589350 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com