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General NPI Number Information
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NPI Number | 1093257891
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Entity Type | Organization
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Legal Business Name | UT SOUTHWESTERN MEDICAL CENTER
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Dates
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Enumeration Date | 11/09/2016
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Last Update Date | 11/09/2016
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Provider Practice Location Address
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Address Line | 2201 INWOOD RD
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City | DALLAS
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State | TX
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Zip | 75235-7320
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Country | US
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Telephone | 469-261-0492
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Fax |
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Provider Business Mailing Address
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Address Line | 4427 DALNY ST
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City | DALLAS
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State | TX
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Zip | 75214-2308
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Country | US
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Telephone | 469-261-0492
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Fax |
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Authorized Official
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Title or Position | MEDICAL ONCOLOGY APRN
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Name | MRS. LEAH SKELTON
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Credential | FNP-C
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Telephone | 469-261-0492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | AP131872
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License Number State | TX
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