Provider Demographics
NPI:1073971164
Name:THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON
Entity Type:Organization
Organization Name:THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON
Other - Org Name:UTHEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROSENBLATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:713-500-2457
Mailing Address - Street 1:1825 PRESSLER ST
Mailing Address - Street 2:ROOM SRB 509
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3725
Mailing Address - Country:US
Mailing Address - Phone:713-500-2457
Mailing Address - Fax:713-500-2420
Practice Address - Street 1:1825 PRESSLER ST
Practice Address - Street 2:ROOMS SRB 510 & 511
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3725
Practice Address - Country:US
Practice Address - Phone:713-500-2457
Practice Address - Fax:713-500-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2036245OtherCLINICAL LABORATORY IMPROVEMENT AMENDMENTS