1871522771 NPI number — UNIVERSITY OF TEXAS AT AUSTIN

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 1871522771 NPI number — UNIVERSITY OF TEXAS AT AUSTIN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF TEXAS AT AUSTIN
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:
UNIVERSITY OF TEXAS AT AUSTIN SPEECH & HEARING CENTER
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:
1871522771
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 UNIVERSITY STATION A1100
Provider Second Line Business Mailing Address:
1 UNIVERSITY STATION A1100 CMA 2200
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78712
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-471-3841
Provider Business Mailing Address Fax Number:
512-232-1804

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2504 A WHITIS
Provider Second Line Business Practice Location Address:
2504 A WHITIS CMA 2200
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-471-3841
Provider Business Practice Location Address Fax Number:
512-232-1804
Provider Enumeration Date:
07/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHAMPLIN
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHAIR
Authorized Official Telephone Number:
512-471-6345

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 0009BT . This is a "BCBS" identifier . This identifiers is of the category "OTHER".




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