The University of Texas Southwestern Medical Center at Dallas
Organization
Active NPI
Physical Medicine & Rehabilitation Physician · Tyler, TX
NPI 1417099599 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1417099599
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Medicine & Rehabilitation Physician 208100000X
- Legal business name
- THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
- Practice address
- 1000 S Beckham Ave
Tyler, TX 75701-1908
- Phone
- (214) 645-0624
- Fax
- (214) 645-0078
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Bruce Fairbanks
- Title
- Vice President
- Phone
- (214) 645-0624
Other NPIs on the same Medicare enrollment 43
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
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University of Texas Southwestern Medical Center at Dallas Rehabilitation Clinic/Center · Dallas, TX · NPI 1043418205
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University of Texas Southwestern Medical Center at Dallas Orthopaedic Surgery Physician · Dallas, TX · NPI 1083669766
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University of Texas Southwestern Medical Center at Dallas Anatomic Pathology & Clinical Pathology Physician · Dallas, TX · NPI 1104891050
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University of Texas Southwestern Medical Center at Dallas Certified Registered Nurse Anesthetist · Dallas, TX · NPI 1114992161
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University of Texas Southwestern Medical Center at Dallas Vascular Surgery Physician · Dallas, TX · NPI 1134173966
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University of Texas Southwestern Medical Center at Dallas Emergency Medicine Physician · Dallas, TX · NPI 1205880036
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University of Texas Southwestern Medical Center at Dallas Ophthalmology Physician · Fort Worth, TX · NPI 1225082050
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University of Texas Southwestern Medical Center at Dallas Internal Medicine Physician · El Paso, TX · NPI 1235384199
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University of Texas Southwestern Medical Center at Dallas Obstetrics & Gynecology Physician · Plano, TX · NPI 1518984988
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University of Texas Southwestern Medical Center at Dallas Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Dallas, TX · NPI 1548215247
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University of Texas Southwestern Medical Center at Dallas Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Odessa, TX · NPI 1588804496
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University of Texas Southwestern Medical Center at Dallas Neurological Surgery Physician · Dallas, TX · NPI 1639124332
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University of Texas Southwestern Medical Center at Dallas Orthopaedic Surgery Physician · Arlington, TX · NPI 1689987851
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University of Texas Southwestern Medical Center at Dallas Obstetrics & Gynecology Physician · Dallas, TX · NPI 1710959135
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View all 43
Corporate family (same tax ID) 24
Organizations that report the same tax identification number in the National Provider Directory.
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Texas Southwestern Medical Center at Dallas Orthotic Fitter · Dallas, TX · NPI 1326135732
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The University of Texas Southwestern Medical Center at Dallas Radiation Oncology Clinic/Center · Dallas, TX · NPI 1497720353
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University of Texas Southwestern Medical Center at Dallas Oral and Maxillofacial Surgery (Dentist) · Dallas, TX · NPI 1306976865
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University of Texas Southwestern Medical Center at Dallas Prosthetic/Orthotic Supplier · Dallas, TX · NPI 1316912363
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University of Texas Southwestern Medical Center at Dallas General Acute Care Hospital · Dallas, TX · NPI 1477807436
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University of Texas Southwestern Medical Center at Dallas Obstetrics & Gynecology Physician · Plano, TX · NPI 1518984988
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University of Texas Southwestern Medical Center at Dallas Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Dallas, TX · NPI 1548215247
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University of Texas Southwestern Medical Center at Dallas Clinical Medical Laboratory · Dallas, TX · NPI 1588751903
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University of Texas Southwestern Medical Center at Dallas Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · Odessa, TX · NPI 1588804496
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University of Texas Southwestern Medical Center at Dallas Neurological Surgery Physician · Dallas, TX · NPI 1639124332
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University of Texas Southwestern Medical Center at Dallas Orthopaedic Surgery Physician · Arlington, TX · NPI 1689987851
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Ut Southwestern Medical Center Children's Hospital · Dallas, TX · NPI 1245592997
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Utsouthwestern Medical Center Clinical Medical Laboratory · Dallas, TX · NPI 1245500305
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|
| O20031106000792 |
TX |
Part B Supplier - Clinic/Group Practice |
0648188250 |
Receives reassigned benefits from 5,689 practitioners
46 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Genetic Diagnostic Group (79 organizations share this tax ID)
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|
Physical Medicine & Rehabilitation Physician
Group: 193200000X MULTI-SPECIALTY GROUP |
208100000X |
|
|
Yes |
Addresses
Primary practice location
1000 S Beckham Ave
Tyler, TX 75701-1908
Mailing address
PO Box 854347
Dallas, TX 75284-5347
Phone (214) 645-0624
Other names
- UT SOUTHWESTERN PHYSICAL MEDICINE AND REHABILITATION Other name