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NPI Code Detail

MEDICARE: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS

MEDICARE: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
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
12085R0202XDiagnostic Radiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811039381
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-5347
Country : US
Telephone Number : 214-645-0624
Fax Number : 214-645-0078
Provider Business Practice Location Address
First Line : 7609 PRESTON RD
Second Line :
City : PLANO
State : TX
Zip : 75024-3214
Country : US
Telephone Number : 214-645-0624
Fax Number : 214-645-0078
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : BRUCE A. MEYER
Credential : M.D.
Telephone Number : 214-648-0309
Provider Enumeration Date : 02/13/2007
Last Update Date : 01/17/2018

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Directions to “UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS ” Practice Location

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