Provider Demographics
NPI:1831120336
Name:UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER, SAN ANTONIO
Entity Type:Organization
Organization Name:UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER, SAN ANTONIO
Other - Org Name:UT ALLIED HEALTH THERAPEUTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM DEAN SCH OF HEALTH PROF.
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:210-567-8800
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:MAIL CODE 6243
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-567-8800
Mailing Address - Fax:210-567-8807
Practice Address - Street 1:8403 FLOYD CURL DR
Practice Address - Street 2:MAIL CODE 6243
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3904
Practice Address - Country:US
Practice Address - Phone:210-567-8800
Practice Address - Fax:210-567-8807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2020174 01Medicaid
TX454879Medicare Oscar/Certification