Provider Demographics
NPI:1528234911
Name:UTHSCSA
Entity type:Organization
Organization Name:UTHSCSA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HUMA
Authorized Official - Middle Name:ATIQUE
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-567-4003
Mailing Address - Street 1:7703 FLOYD CURL DR # MC7750
Mailing Address - Street 2:UTHSCSA, DEPT OF PATHOLOGY
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-567-4003
Mailing Address - Fax:
Practice Address - Street 1:7703 FLOYD CURL DR # MC7750
Practice Address - Street 2:UTHSCSA, DEPT OF PATHOLOGY
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3901
Practice Address - Country:US
Practice Address - Phone:210-567-4003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0920282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital