=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831120336
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER, SAN ANTONIO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2006
-----------------------------------------------------
Last Update Date | 04/22/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8403 FLOYD CURL DR MAIL CODE 6243
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-3904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-567-8800
-----------------------------------------------------
Fax | 210-567-8807
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7703 FLOYD CURL DR MAIL CODE 6243
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78229-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-567-8800
-----------------------------------------------------
Fax | 210-567-8807
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | INTERIM DEAN SCH OF HEALTH PROF.
-----------------------------------------------------
Name | DR. DOUGLAS L MURPHY
-----------------------------------------------------
Credential | PH.D
-----------------------------------------------------
Telephone | 210-567-8800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0401X
-----------------------------------------------------
Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------