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General NPI Number Information
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NPI Number | 1275838732
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
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Dates
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Enumeration Date | 01/14/2011
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Last Update Date | 05/07/2021
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Provider Practice Location Address
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Address Line | 470 EAST STATE HWY 114
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City | SOUTHLAKE
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State | TX
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Zip | 76092-7625
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Country | US
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Telephone | 214-645-0624
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Fax | 214-645-0624
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Provider Business Mailing Address
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Address Line | PO BOX 845347
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City | DALLAS
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State | TX
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Zip | 75284-7208
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Country | US
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Telephone | 214-645-0624
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Fax | 214-645-0078
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | BRUCE A. MEYER
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Credential | M.D.
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Telephone | 214-645-0624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 207RI0008X
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Taxonomy Name | Hepatology Physician
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License Number |
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License Number State |
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Taxonomy #12
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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