Provider Demographics
NPI:1215289632
Name:SOUTHERN METHODIST UNIVERSITY
Entity type:Organization
Organization Name:SOUTHERN METHODIST UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE A.D./BUSINESS & FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:214-768-3585
Mailing Address - Street 1:5800 OWNBY DR
Mailing Address - Street 2:PO BOX 730315
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75275-0315
Mailing Address - Country:US
Mailing Address - Phone:214-768-2808
Mailing Address - Fax:214-768-1225
Practice Address - Street 1:5800 OWNBY DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75275-0315
Practice Address - Country:US
Practice Address - Phone:214-768-2808
Practice Address - Fax:214-768-1225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health