NPIMap

Organization Active NPI

Unthsc

  • Clinical Medical Laboratory
  • Fort Worth, TX
National Provider Identifier
1790095362
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
UNTHSC
Practice address
3500 Camp Bowie Blvd
Ft Worth, TX 76107
Phone
(817) 735-2000
NPI assigned
Oct 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leslie Henderson
Title
Revenue Cycle Director
Phone
(817) 735-2008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

3500 Camp Bowie Blvd
Ft Worth, TX 76107

Mailing address

3500 Camp Bowie Blvd
Ft Worth, TX 76107-2644
Phone (817) 735-2000

Other names 1

  • University of North Texas Health Science Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Jon C Sivoravong MD11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528416000000",
    "number": "1790095362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 CAMP BOWIE BLVD",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761072644",
            "telephone_number": "817-735-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CAMP BOWIE BLVD",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "76107",
            "telephone_number": "817-735-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNTHSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2018-06-08",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "817-735-2008"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University of North Texas Health Science Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "University of North Texas Health Science Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.