# UT PHYSICIANS CHOSEN CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093868630
- **Authorized official:** ANDREW R CASAS (VICE PRESIDENT)
- **Authorized official phone:** (832) 325-7317

## Contact information

- **Practice address:** 6410 FANNIN ST, 720, HOUSTON, TX 77030-3000
- **Practice address phone:** (832) 325-7298
- **Mailing address:** PO BOX 301173, DALLAS, TX 75303-1173
- **Mailing address phone:** (713) 500-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | Yes |
| 171M00000X | Case Manager/Care Coordinator | — | — | Yes |

## Other

- **Enumeration date:** 01/18/2007
- **Last updated:** 12/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 181590401 | — | TX |