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General NPI Number Information
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NPI Number | 1609420025
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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 | 07/25/2019
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5303 HARRY HINES BLVD SUITE 100 JAMES ASTON AMBULATORY CARE CENTER
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City | DALLAS
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State | TX
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Zip | 75390-8862
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Country | US
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Telephone | 214-648-2422
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Fax | 214-648-2652
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Provider Business Mailing Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-9922
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Country | US
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Telephone | 469-525-5908
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Fax | 214-648-2652
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Authorized Official
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Title or Position | CFO
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Name | MARK ALAN MEYER
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Credential |
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Telephone | 214-633-4804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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