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Organization

TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS

Active
Other names
UTSW Medical Center Urological Surgery
Organization subpart
No

Provider details

NPI number
Authorized official
BRUCE FAIRBANKS (VICE PRESIDENT)
(214) 648-0309
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary

Other

Enumeration date
07/21/2006
Last updated
08/22/2020
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