| Ut Msp Family Practice | |
|
5323 Harry Hines Blvd Dallas TX 75390-7208 | |
| (214) 645-0624 | |
| (214) 645-0078 |
| Full Name | Ut Msp Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 5323 Harry Hines Blvd, Dallas, Texas |
| Authorized Official Name and Position | Bruce A. Meyer (EXECUTIVE VICE PRESIDENT) |
| Authorized Official Contact | 2146450624 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ut Msp Family Practice Po Box 845347 Dallas TX 75284-5347 Ph: (214) 645-0624 | Ut Msp Family Practice 5323 Harry Hines Blvd Dallas TX 75390-7208 Ph: (214) 645-0624 |
| NPI Number | 1760452387 |
|---|---|
| Provider Enumeration Date | 01/25/2006 |
| Last Update Date | 02/15/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760452387 | NPI | - | NPPES |
| 081891604 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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