Provider Demographics
NPI:1073969309
Name:UNIVERSITY OF HOUSTON
Entity Type:Organization
Organization Name:UNIVERSITY OF HOUSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-743-8504
Mailing Address - Street 1:126 HEYNE BLDG
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY, UNIVERSITY OF HOUSTON
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-7089
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2015 THOMAS ST
Practice Address - Street 2:THOMAS STREET CLINIC, HARRIS HEALTH
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-8044
Practice Address - Country:US
Practice Address - Phone:713-236-7125
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37032261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service