# TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UTSW Medical Center Urological Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164443909
- **Authorized official:** BRUCE FAIRBANKS (VICE PRESIDENT)
- **Authorized official phone:** (214) 648-0309

## Contact information

- **Practice address:** 7800 PRESTON RD, SUITE 300, PLANO, TX 75024
- **Practice address phone:** (214) 645-0624
- **Practice address fax:** (214) 645-0078
- **Mailing address:** PO BOX 845347, DALLAS, TX 75284-5347
- **Mailing address phone:** (214) 645-0624
- **Mailing address fax:** (214) 645-0078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/21/2006
- **Last updated:** 08/22/2020