Provider Demographics
NPI:1962691006
Name:THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUSTON
Entity type:Organization
Organization Name:THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER HOUSTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUJILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-500-8375
Mailing Address - Street 1:6655 TRAVIS ST
Mailing Address - Street 2:400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1312
Mailing Address - Country:US
Mailing Address - Phone:713-500-8360
Mailing Address - Fax:
Practice Address - Street 1:6655 TRAVIS ST
Practice Address - Street 2:400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1312
Practice Address - Country:US
Practice Address - Phone:713-500-8360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE UNIVERSITY OF TEXAS HEALTH SCIENCE AT HOUSTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-15
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center