MEDICARE: UT PHYSICIANS SPECIALTY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0030PG	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801945027
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UT PHYSICIANS SPECIALTY SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 301448
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75303-1448
Country	:	US
Telephone Number	:	713-500-3500
Fax Number	:	713-500-8630

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST
Second Line	:	SUITE 170
City	:	HOUSTON
State	:	TX
Zip	:	77030-3000
Country	:	US
Telephone Number	:	832-325-6500
Fax Number	:

Authorized Official
Title or Position	:	INTERIM CHIEF OPERATING OFFICER
Name	:	CYNTHIA HUEHLEFELD
Credential	:
Telephone Number	:	832-325-7325

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	03/26/2026

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Directions to “UT PHYSICIANS SPECIALTY SERVICES ” Practice Location

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