Provider Demographics
NPI:1346551959
Name:UNIVERSITY OF NORTH TEXAS
Entity type:Organization
Organization Name:UNIVERSITY OF NORTH TEXAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR HEALTHCARE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:CALAME
Authorized Official - Last Name:HABERN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-261-7234
Mailing Address - Street 1:1155 UNION CIR # 305160
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76203-5017
Mailing Address - Country:US
Mailing Address - Phone:940-565-2333
Mailing Address - Fax:940-565-4559
Practice Address - Street 1:1800 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201
Practice Address - Country:US
Practice Address - Phone:940-565-2333
Practice Address - Fax:940-565-4559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF NORTH TEXAS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty
No261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health