Provider Demographics
NPI:1972853810
Name:UNIVERSITY OF HOUSTON SYSTEM
Entity type:Organization
Organization Name:UNIVERSITY OF HOUSTON SYSTEM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:CASC
Authorized Official - Phone:713-743-7503
Mailing Address - Street 1:4349 MARTIN LUTHER KING BLVD RM 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-2050
Mailing Address - Country:US
Mailing Address - Phone:713-743-7141
Mailing Address - Fax:713-743-7142
Practice Address - Street 1:4349 MARTIN LUTHER KING BLVD 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204-2050
Practice Address - Country:US
Practice Address - Phone:713-743-7141
Practice Address - Fax:713-743-7142
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF HOUSTON SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-19
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX130125261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX296789OtherPTAN
TX45C0001545OtherCMS CCN