Organization
UT SOUTHWESTERN MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE BLUE (MEDICAL STAFF CREDENTIALING)
(214) 645-7811
Entity
Organization
Contact information
Practice address
UT SOUTHWESTERN MEDICAL CTR, NEUROPSYCHOLOGY 8846, 5323 HARRY HINES BLVD, DALLAS, TX 75390-0001
(214) 648-4687
Mailing address
UT SOUTHWESTERN MEDICAL CTR, NEUROPSYCHOLOGY 8846, 5323 HARRY HINES BLVD, DALLAS, TX 75390-0001
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
36320
TX
261QM0850X
Adult Mental Health Clinic/Center
6301014547
MI
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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