OrganizationActive
The University of Texas Southwestern Medical Center at Dallas
NPI 1417099599 · Physical Medicine & Rehabilitation Physician · Tyler, TX
Provider details
- NPI number
- 1417099599
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Bruce Fairbanks, Vice President(214) 645-0624
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1000 S Beckham Ave
Tyler, TX 75701-1908
Phone: (214) 645-0624
Fax: (214) 645-0078
Street-level locationGet directions
Mailing address
Po Box 854347
Dallas, TX 75284-5347
Other names (DBA / former)
- Other name
- Ut Southwestern Physical Medicine and Rehabilitation
Registry dates
- Enumerated
- 2007-02-13
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.