Organization
THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Active
Other names
UT SOUTHWESTERN PHYSICAL MEDICINE AND REHABILITATION
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE FAIRBANKS (VICE PRESIDENT)
(214) 645-0624
Entity
Organization
Contact information
Practice address
1000 S BECKHAM AVE, TYLER, TX 75701-1908
(214) 645-0624
(214) 645-0078
Mailing address
PO BOX 854347, DALLAS, TX 75284-5347
(214) 645-0624
(214) 645-0078
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
02/13/2007
Last updated
08/22/2020
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