MEDICARE: UT PHYSICIANS

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	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1942729728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UT PHYSICIANS

Provider Business Mailing Address
First Line	:	PO BOX 301173
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75303-1173
Country	:	US
Telephone Number	:	832-325-7325
Fax Number	:

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST STE 1500
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-5306
Country	:	US
Telephone Number	:	832-325-7325
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	ANDREW R CASAS
Credential	:
Telephone Number	:	832-325-7325

Provider Enumeration Date	:	09/13/2017
Last Update Date	:	09/13/2017

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Directions to “UT PHYSICIANS ” Practice Location

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