Provider Demographics
NPI:1831372911
Name:THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON
Entity type:Organization
Organization Name:THE UNIVERSITY OF TEXAS HEALTH SCIENCE CENTER AT HOUSTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DEAN OF PATIENT CARE
Authorized Official - Prefix:DR
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'NEILL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-500-4001
Mailing Address - Street 1:6516 M D ANDERSON BLVD
Mailing Address - Street 2:SUITE 156
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3402
Mailing Address - Country:US
Mailing Address - Phone:710-500-4001
Mailing Address - Fax:
Practice Address - Street 1:6516 M D ANDERSON BLVD
Practice Address - Street 2:SUITE 156
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3402
Practice Address - Country:US
Practice Address - Phone:710-500-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty