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NPI Code Detail

MEDICARE: UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO

MEDICARE: UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO
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
1261QD0000XDental Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1121876004OTHERTXCIDC/ MEDICAL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1760424873
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO
Provider Business Mailing Address
First Line : PO BOX 40397
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-1397
Country : US
Telephone Number : 210-567-6405
Fax Number :
Provider Business Practice Location Address
First Line : 8210 FLOYD CURL DR
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3923
Country : US
Telephone Number : 210-567-6405
Fax Number :
Authorized Official
Title or Position : DENTAL SCHOOL DEAN
Name : DR. PETER LOOMER
Credential : D.D.S
Telephone Number : 210-567-6405
Provider Enumeration Date : 06/12/2006
Last Update Date : 01/05/2024

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Directions to “UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO ” Practice Location

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