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NPI Code Detail

MEDICARE: UT PHYSICIANS SPECIALTY SERVICES

MEDICARE: UT PHYSICIANS SPECIALTY SERVICES
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
1208000000XPediatrics Physician

Other Identifiers

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

General Provider Information

NPI Number : 1437670411
Entity Type Code : Organization
Provider Name (Legal Business Name) : UT PHYSICIANS SPECIALTY SERVICES
Provider Business Mailing Address
First Line : PO BOX 301173
Second Line :
City : DALLAS
State : TX
Zip : 75303-1173
Country : US
Telephone Number : 713-500-3500
Fax Number :
Provider Business Practice Location Address
First Line : 1200 BINZ ST STE 850
Second Line :
City : HOUSTON
State : TX
Zip : 77004-6933
Country : US
Telephone Number : 713-486-5660
Fax Number :
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : ANDREW CASAS
Credential :
Telephone Number : 832-325-7325
Provider Enumeration Date : 06/29/2017
Last Update Date : 06/29/2017

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Directions to “UT PHYSICIANS SPECIALTY SERVICES ” Practice Location

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