MEDICARE: THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104865013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON

Provider Business Mailing Address
First Line	:	7500 CAMBRIDGE ST # 3410
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2032
Country	:	US
Telephone Number	:	713-500-8220
Fax Number	:	712-500-8210

Provider Business Practice Location Address
First Line	:	7500 CAMBRIDGE ST STE 3410
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2032
Country	:	US
Telephone Number	:	713-500-8220
Fax Number	:	712-500-8210

Authorized Official
Title or Position	:	DIRECTOR OF PATIENT SERVICES
Name	:	ANNA TRIEU
Credential	:
Telephone Number	:	713-486-4242

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	10/27/2022

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