Organization
UTMB FACULTY GROUP PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA L. SMITH (DIRECTOR)
(409) 772-2222
Entity
Organization
Contact information
Practice address
313 E 12TH ST, AUSTIN, TX 78701-1954
(409) 772-2222
Mailing address
P O BOX 4797-710, HOUSTON, TX 77210-4797
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112048705
—
TX
Enumeration date
06/09/2006
Last updated
09/22/2009
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