Provider Demographics
NPI:1326711516
Name:UNIVERSITY OF TEXAS HEALTH SCIENCE
Entity Type:Organization
Organization Name:UNIVERSITY OF TEXAS HEALTH SCIENCE
Other - Org Name:UT HEALTH SCIENCE CENTER HOUSTON SCHOOL OF PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. EXECUTIVE VP, COO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CPA
Authorized Official - Phone:713-500-3535
Mailing Address - Street 1:ONE UNIVERSITY BLVD., SPH BUILDING
Mailing Address - Street 2:S-1.330
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-4936
Mailing Address - Country:US
Mailing Address - Phone:956-755-0637
Mailing Address - Fax:956-755-0606
Practice Address - Street 1:780 RINGGOLD RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-4936
Practice Address - Country:US
Practice Address - Phone:956-755-0637
Practice Address - Fax:956-755-0606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-26
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory