Provider Demographics
NPI:1316092562
Name:TEXAS A&M UNIVERSITY SYSTEM HEALTH UNIVERSITY HEALTH SERVICES
Entity type:Organization
Organization Name:TEXAS A&M UNIVERSITY SYSTEM HEALTH UNIVERSITY HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-458-8265
Mailing Address - Street 1:1264 TAMU
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77843
Mailing Address - Country:US
Mailing Address - Phone:979-458-8265
Mailing Address - Fax:979-458-8261
Practice Address - Street 1:311 HOUSTON ST
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77843
Practice Address - Country:US
Practice Address - Phone:979-458-8265
Practice Address - Fax:979-458-8261
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS A&M UNIVERSITY SYSTEM HEALTH UNIVERSITY HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-25
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0210053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3658148-01Medicaid
TX3658148-01Medicaid