Provider Demographics
NPI:1346368107
Name:UNIVERSITY OF TEXAS UNIVERSITY HEALTH SERVICES
Entity Type:Organization
Organization Name:UNIVERSITY OF TEXAS UNIVERSITY HEALTH SERVICES
Other - Org Name:UNIVERSITY HEALTH SERVICES LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPALDING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-475-8349
Mailing Address - Street 1:PO BOX 7339
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78713-7339
Mailing Address - Country:US
Mailing Address - Phone:512-475-8247
Mailing Address - Fax:512-475-8369
Practice Address - Street 1:100 WEST DEAN KEETON STREET
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705
Practice Address - Country:US
Practice Address - Phone:512-475-8247
Practice Address - Fax:512-475-8369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory