Provider Demographics
NPI:1124344940
Name:UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUST
Entity type:Organization
Organization Name:UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUST
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:PARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-500-3255
Mailing Address - Street 1:3131 E. HOLCOMBE BLVD.
Mailing Address - Street 2:ATTENTION BENEFITS
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021
Mailing Address - Country:US
Mailing Address - Phone:713-500-3261
Mailing Address - Fax:713-500-3263
Practice Address - Street 1:6641 GRAND BLVD.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021
Practice Address - Country:US
Practice Address - Phone:713-500-3261
Practice Address - Fax:713-500-3263
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUSTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRN558719261QP2300X
TXK3050261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care