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Organization
UT PHYSICIANS SPECIALTY SERVICES
Active
Organization
UT PHYSICIANS SPECIALTY SERVICES
Active
Other names
UT PHYSICIANS ACO DANNY JACKSON
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW CASAS (CHIEF OPERATING OFFICER)
(832) 325-7325
Entity
Organization
Contact information
Practice address
5503 FRY RD, KATY, TX 77449
(713) 449-5845
Mailing address
PO BOX 301448, DALLAS, TX 75303-1448
(281) 837-2700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195996723
—
TX
Enumeration date
07/11/2018
Last updated
07/11/2018
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