# UT SOUTHWESTERN

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

## Provider details

- **NPI number:** 1477091452
- **Authorized official:** DR. MICHAEL RUBIN (SUPERVISOR)
- **Authorized official phone:** (214) 648-6410

## Contact information

- **Practice address:** 5323 HARRY HINES BLVD, DALLAS, TX 75390-8813
- **Practice address phone:** (210) 677-5410
- **Mailing address:** 5323 HARRY HINES BLVD, DALLAS, TX 75390-8813
- **Mailing address phone:** (210) 677-5410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2100X | Acute Care Nurse Practitioner | 701376 | TX | Yes |

## Other

- **Enumeration date:** 02/09/2017
- **Last updated:** 02/09/2017