UTMB FACULTY GROUP PRACTICE (NPI# 1114968294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114968294 |
| Entity Type | Organization |
| Organization Name | UTMB FACULTY GROUP PRACTICE |
| Practice Address |
313 E 12th St Austin TX 78701-1954 |
| Mailing Address |
P O Box 4797-710 Houston TX 77210-4797 |
| Practice Telephone | 4097722222 |
| Mailing Telephone | 4097722222 |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2009-09-22 |
| Authorized Official Name | MRS. CYNTHIA L. SMITH (DIRECTOR) |
| Authorized Official Telephone | 4097722222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 112048705 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760423974 | Utmb Faculty Group Practice | Psychiatry & Neurology | 206 Mimms Ave, Nacogdoches, TX 75961-5028 | 2006-06-09 |
| 1629019823 | Utmb Faculty Group Practice | Surgery | 4616 Broadway St, Ste. F, Pearland, TX 77581-3956 | 2006-06-09 |
| 1821039058 | Utmb Faculty Group Practice | Clinic/Center | 950 Washington Blvd, Beaumont, TX 77705-2251 | 2006-06-09 |
| 1083703433 | Utmb Faculty Group Practice | Clinic/Center | 301 University Blvd, Route 1022, Galveston, TX 77555-5302 | 2006-10-12 |
| 1942241146 | Utmb Faculty Group Practice | Dermatology | 301 University Blvd, Galveston, TX 77555-5302 | 2006-06-09 |
| 1154362382 | Utmb Faculty Group Practice | Psychiatry & Neurology | 3737 Red Bluff Rd, Ste. 150, Pasadena, TX 77503-3307 | 2006-06-09 |
| Street Address |
313 E 12TH ST |
| City | AUSTIN |
| State | TX |
| Zip Code | 78701-1954 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497748370 | Deborah Elaine Briggs | Family Medicine | 313 E 12th St, Austin, TX 78701-1954 | 2005-08-26 |
| 1225503675 | Karen Quach | Pharmacist | 313 E 12th St, Austin, TX 78701-1954 | 2018-10-11 |
| 1881126357 | Marcia Jovel Landin | Nurse Practitioner | 313 E 12th St, Suite 104, Austin, TX 78701-1954 | 2017-04-03 |
| 1184859225 | Jennifer Vickers | Dermatology | 313 E 12th St, Ste 100, Austin, TX 78701-1954 | 2009-05-19 |
| 1972755635 | Jeanette L Bettes | Physician Assistant | 313 E 12th St, Suite 100, Austin, TX 78701-1954 | 2008-10-14 |
| 1962691550 | Candace Ashton | Nurse Practitioner | 313 E 12th St, Suite 101, Austin, TX 78701-1954 | 2007-10-18 |
| 1013102599 | Kimberly Cheryl Butrum | Nurse Practitioner | 313 E 12th St, Suite 101, Austin, TX 78701-1954 | 2007-09-07 |
| 1245421429 | Ammar Moin Ahmed | Dermatology | 313 E 12th St, Suite 101, Austin, TX 78701-1954 | 2007-08-05 |
| 1699973206 | Sarah W Rudinsky | Nurse Practitioner | 313 E 12th St, Austin, TX 78701-1954 | 2007-07-05 |
| 1316143407 | Chandrini Menka Jayasundera | Internal Medicine | 313 E 12th St, Austin, TX 78701-1954 | 2007-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710501820 | Megan Elise Gittins | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School 1400 Ih-35, Cec 300, Austin, TX 78701 | 2020-06-04 |
| 1306467956 | Jason Russell Paxman | Internal Medicine | Dell Seton Medical Center 1500 Red River, Austin, TX 78701 | 2020-05-05 |
| 1992326078 | Sarah N Ibanez Shaw | Emergency Medicine | Ut Austin Dell Medical School Em Residency Program, 1400 N. I-35, Suite 2.230, Austin, TX 78701 | 2020-04-30 |
| 1215558689 | Margaret Marie Coates | Student in an Organized Health Care Education/Training Program | 1400 N Interstate Highway 35, Cec 2.404, Austin, TX 78701 | 2020-04-27 |
| 1740817956 | Woody Starcloud Green | Emergency Medicine | Dell Emergency Medicine Residency Program, 1400 N. Interstate Hwy 35, Suite 2.230, Austin, TX 78701 | 2020-03-26 |
| 1235771403 | Central Ortho Assists Pllc | Physician Assistant | 501 Congress, Suite 150, Austin, TX 78701 | 2019-10-09 |
| 1114575792 | Shyneice Lasha Gaddis | Behavior Technician | 100 Congress Ave Suite 2000, Austin, TX 78701 | 2019-08-28 |
| 1245887355 | Jonathan Thomas Mason | Family Medicine | 1400 N-ih 35, Dell Seton Medical Center, Ste C2.410, Austin, TX 78701 | 2019-08-22 |
| 1538726195 | Zahra Virginia Cain-akbar | Student in an Organized Health Care Education/Training Program | Ut Dell Medical, 1500 Red River St, Austin, TX 78701 | 2019-05-20 |
| 1457918021 | Sara Lugonjic | Student in an Organized Health Care Education/Training Program | Ut Austin Dell Medical School Neurology Program, 1400 Ih- 35, Cec 300, Austin, TX 78701 | 2019-05-20 |
| Find all providers in zip 78701 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1619328283 | Neurotech Austin | Clinic/Center | 2712 Bee Caves Rd, Suite 102, Austin, TX 78746-5676 | 2016-06-24 |
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| Find all providers in AUSTIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.