Organization
GENETIC DIAGNOSTIC GROUP
Active
Parent organization
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Authorized official
BRUCE FAIRBANKS (VICE PRESIDENT)
(214) 648-0309
Entity
Organization
Contact information
Practice address
6000 HARRY HINES BLVD, HAMON BLDG, ROOM NA2 508A, DALLAS, TX 75390-0001
(214) 645-0624
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(214) 645-0624
Taxonomy
Speciality
Code
Description
License number
State
207SG0202X
Clinical Biochemical Genetics Physician
Primary
—
—
Other
Enumeration date
10/23/2008
Last updated
02/24/2011
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