Provider Demographics
NPI:1649352303
Name:UNIVERSITY CARE PLUS WEATHERHEAD PET CENTER
Entity type:Organization
Organization Name:UNIVERSITY CARE PLUS WEATHERHEAD PET CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:CASAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-325-7317
Mailing Address - Street 1:PO BOX 301365
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75303-1365
Mailing Address - Country:US
Mailing Address - Phone:713-500-6611
Mailing Address - Fax:713-500-6615
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:HG009
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6611
Practice Address - Fax:713-500-6615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX327348401Medicaid
TX327348401Medicaid