| Organization Name: | TEXAS STATE UNIVERSITY STUDENT HEALTH CENTER |
| NPI Number: | 1003953050 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | EMILIO CARRANCO (DIRECTOR) |
| Mailing Address: | 298 Student Center Drive San Marcos |
| State: | TX US |
| Postal Code: | 78666 |
| Phone Number: | 5122452161 |
| Fax Number: | 5122453918 |
| NPI Enumeration Date: | 01/31/2007 |
| NPI Last Update Date: | 05/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QS1000X |
| License Number: | G4896 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Student Health |
| Taxonomy Definition: | |