Provider Demographics
NPI:1447674908
Name:UNIVERSAL INTEREST, LLC
Entity type:Organization
Organization Name:UNIVERSAL INTEREST, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-773-6655
Mailing Address - Street 1:PO BOX 780896
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-0896
Mailing Address - Country:US
Mailing Address - Phone:210-773-6655
Mailing Address - Fax:
Practice Address - Street 1:2700 CITIZENS PLZ STE 402
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5757
Practice Address - Country:US
Practice Address - Phone:361-582-5633
Practice Address - Fax:361-582-5632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSAL INTEREST, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-04
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty