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
1	207V00000X	Obstetrics & Gynecology Physician
2	207Q00000X	Family Medicine Physician
3	207X00000X	Orthopaedic Surgery Physician
4	2084P0800X	Psychiatry Physician
5	103T00000X	Psychologist
6	225100000X	Physical Therapist
7	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1982850699
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	:

Provider Business Practice Location Address
First Line	:	1801 INWOOD RD
Second Line	:	7TH FLOOR
City	:	DALLAS
State	:	TX
Zip	:	75235-7202
Country	:	US
Telephone Number	:	214-645-0624
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT
Name	:	BRUCE A. MEYER
Credential	:	M.D.
Telephone Number	:	214-648-0309

Provider Enumeration Date	:	08/13/2008
Last Update Date	:	02/19/2013

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