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General NPI Number Information
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NPI Number | 1215289632
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Entity Type | Organization
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Legal Business Name | SOUTHERN METHODIST UNIVERSITY
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 5800 OWNBY DR
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City | DALLAS
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State | TX
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Zip | 75275-0315
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Country | US
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Telephone | 214-768-2808
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Fax | 214-768-1225
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Provider Business Mailing Address
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Address Line | 5800 OWNBY DR PO BOX 730315
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City | DALLAS
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State | TX
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Zip | 75275-0315
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Country | US
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Telephone | 214-768-2808
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Fax | 214-768-1225
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Authorized Official
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Title or Position | ASSOCIATE A.D./BUSINESS & FINANCE
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Name | KRIS LOWE
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Credential | CPA
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Telephone | 214-768-3585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State |
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