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General NPI Number Information
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NPI Number | 1992736573
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT SAN ANTONIO
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 7703 FLOYD CURL DR. RM 4.194R
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-567-3274
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Fax | 210-567-2844
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Provider Business Mailing Address
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Address Line | 7703 FLOYD CURL DR. RM 4.194R
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-567-3274
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Fax | 210-567-2844
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Authorized Official
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Title or Position | DENTAL SCHOOL VICE DEAN
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Name | DR. WILLIAM DODGE
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Credential | D.D.S.
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Telephone | 210-567-3268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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