Covered Entity Details

DSH450213EV UNIVERSITY HEALTH SYSTEM (Terminated) - information as of 5/14/2025 10:57:37 PM

Main Details

Name

UNIVERSITY HEALTH SYSTEM

Subdivision Name

BEXAR COUNTY HOSPITAL DISTRICT - PHOTOTHERAPY

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH450213EV

Medicare Provider Number

450213

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

1/12/2018

Participating Start Date

4/1/2018

Participating Approval Date

1/23/2018

Last Recertification Date

8/31/2022

Termination Date
Termination Reason

10/1/2023
Other

Contacts

Authorizing Official

University Health System
Reed Hurley, Executive Vice President/CFO
(210) 358-2101 Ext: 2141

Primary Contact

University Health System
Josefa Benedetti, Executive Director of Pharmacy
(210) 743-4077

Addresses

Street Address

701S ZARZAMORA ST
UNIVERSITY CENTER FOR COMMUNITY HEALTH
SAN ANTONIO, TX 78207-5209

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
TX	250252,250387,250372,250182,250478,144902,146578,136141205	1851499453,1164533816,1922119668,1235240979,1336243054,1265536973,1538445861,1447320841,1811320948,1336353309,1700908506,1821011248
MA	110066561B	1821011248

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH450213AA	Child	DSH	UNIVERSITY HEALTH SYSTEM	Dialysis Southeast	1407 Fair Ave	San Antonio	TX	Active
DSH450213AB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Renal Dialysis-Outpatient	7540 Louis Pasteur	San Antonio	TX	Terminated
DSH450213AC	Child	DSH	UNIVERSITY HEALTH SYSTEM	Dialysis South	3750 Commercial Ave	San Antonio	TX	Active
DSH450213AD	Child	DSH	UNIVERSITY HEALTH SYSTEM	Ophthalmology Clinic	701 South Zarzamora	San Antonio	TX	Terminated
DSH450213AE	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Orthopedic	701 S Zarzamora St	San Antonio	TX	Active
DSH450213AF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Podiatry	701 S Zarzamora St	San Antonio	TX	Active
DSH450213AG	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Skin Clinic	903 W Martin St	San Antonio	TX	Active
DSH450213AH	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHCD Lab	903 West Martin	San Antonio	TX	Terminated
DSH450213AJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Acute Care Clinic - UFHCDT	903 West Martin	San Antonio	TX	Terminated
DSH450213AK	Child	DSH	UNIVERSITY HEALTH SYSTEM	Adult Diabetes Clinic	701 South Zarzamora	San Antonio	TX	Terminated
DSH450213AL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pediatric Hematology and Oncology	4502 Medical Dr	San Antonio	TX	Active
DSH450213AM	Child	DSH	UNIVERSITY HEALTH SYSTEM	Westgate Lab	5282 Medical Dr	San Antonio	TX	Active
DSH450213AN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Non-invasive Vascular	903 W Martin St	San Antonio	TX	Active
DSH450213AQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Peritoneal Dialysis	701 S Zarzamora St	San Antonio	TX	Active
DSH450213AR	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest Women's Health	2121 SW 36th St	San Antonio	TX	Active
DSH450213AS	Child	DSH	UNIVERSITY HEALTH SYSTEM	North Lab	302 W Rector St	San Antonio	TX	Active
DSH450213AT	Child	DSH	UNIVERSITY HEALTH SYSTEM	UCCH Lab	701 S. Zarzamora St	san Antonio	TX	Terminated
DSH450213AU	Child	DSH	UNIVERSITY HEALTH SYSTEM	Immunosuppression Clinic	903 W Martin St	San Antonio	TX	Terminated
DSH450213AV	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Refugee Phlebotomy	1033 Ada St	San Antonio	TX	Active
DSH450213AW	Child	DSH	UNIVERSITY HEALTH SYSTEM	Babcock Surgery Clinic	2425 Babcock Rd	San Antonio	TX	Active
DSH450213AX	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest Sonogram	2121 SW 36th St	San Antonio	TX	Active
DSH450213AY	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Ear, Nose, And Throat	903 W Martin St	San Antonio	TX	Active
DSH450213AZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Rio Tower 1st Floor Infusion Center	4502 Medical Dr	San Antonio	TX	Active
DSH450213BA	Child	DSH	UNIVERSITY HEALTH SYSTEM	Surgery Center at the MARC	8300 Floyd Curl Dr	San Antonio	TX	Active
DSH450213BB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Ambulatory Surgical Center	903 W Martin St	San Antonio	TX	Active
DSH450213BC	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - RBG ASC Prep/Recovery	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213BD	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - RBG ASC Endoscopy	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213BE	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric Sports Medicine	903 W Martin St	San Antonio	TX	Active
DSH450213BF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus ExpressMed	903 W Martin St	San Antonio	TX	Active
DSH450213BG	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - Podiatry Clinic	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213BH	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - Oral Surgery Clinic	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213BJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - RBG Primary Care	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213BK	Child	DSH	UNIVERSITY HEALTH SYSTEM	Babcock Behavioral Health	2425 Babcock Rd	SAN ANTONIO	TX	Active
DSH450213BL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Collier School-Based Clinic HISD	834 W Southcross Blvd	San Antonio	TX	Active
DSH450213BM	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatrics	903 W Martin St	San Antonio	TX	Active
DSH450213BN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Developmental and Behavioral Pediatrics	911 Historic Old Hwy 90	San Antonio	TX	Active
DSH450213BP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kennedy Sonogram	1831 S General McMullen Dr	San Antonio	TX	Active
DSH450213BQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Zarzamora Sonogram	4503 S Zarzamora St	San Antonio	TX	Active
DSH450213BR	Child	DSH	UNIVERSITY HEALTH SYSTEM	University Health System - Dr. Robert L.M.Hilliard Center - UMA HILLIARD SPECIALTY	919 Locke St.	San Antonio	TX	Terminated
DSH450213BS	Child	DSH	UNIVERSITY HEALTH SYSTEM	South Flores Radiology	600 E Amber St	San Antonio	TX	Active
DSH450213BT	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute - North	302 W Rector	San Antonio	TX	Terminated
DSH450213BU	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - Adult Medicine	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213BV	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Diabetes Endocrinology	701 S Zarzamora St	San Antonio	TX	Active
DSH450213BW	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion ExpressMed	4647 Medical Dr	San Antonio	TX	Active
DSH450213BX	Child	DSH	UNIVERSITY HEALTH SYSTEM	Westgate Family Medicine	5282 Medical Dr	San Antonio	TX	Active
DSH450213BY	Child	DSH	UNIVERSITY HEALTH SYSTEM	NW Clinic MHCM	7726 Louis Pasteur	San Antonio	TX	Terminated
DSH450213BZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Callaghan	8210 Callaghan	San Antonio	TX	Terminated
DSH450213CA	Child	DSH	UNIVERSITY HEALTH SYSTEM	North Family Medicine	302 W Rector St	San Antonio	TX	Active
DSH450213CB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Refugee Clinic	1033 Ada St	San Antonio	TX	Active
DSH450213CC	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kenwood Sonogram	302 Dora St	San Antonio	TX	Active
DSH450213CD	Child	DSH	UNIVERSITY HEALTH SYSTEM	Naco Perrin Sonogram	4020 Naco Perrin Blvd	San Antonio	TX	Active
DSH450213CE	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - Children's Clinic	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213CF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest Family Medicine	2121 SW 36th St	San Antonio	TX	Active
DSH450213CG	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Cardiology	1055 Ada St	San Antonio	TX	Active
DSH450213CH	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Children's Health	903 W Martin St	San Antonio	TX	Active
DSH450213CJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT / RBG Urology	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213CK	Child	DSH	UNIVERSITY HEALTH SYSTEM	Medical Center Pavilion Pediatrics	4647 Medical Dr	San Antonio	TX	Active
DSH450213CL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Mobile Primary Care	903 W Martin St	San Antonio	TX	Active
DSH450213CM	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT / TDI Neurology Clinic	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213CN	Child	DSH	UNIVERSITY HEALTH SYSTEM	University Health System - Dr. Robert L.M. Hilliard Center -General Family Medicine Clinic	919 Locke St.	San Antonio	TX	Terminated
DSH450213CP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest School-Based Clinic SWISD	11914 Dragon Ln	San Antonio	TX	Active
DSH450213CQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - PEDIATRIC ENDOCRINOLOGY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213CS	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - DIABETES CLINIC RESEARCH	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213CT	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - BWIC OBSERVATION	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213CU	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CHF CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213CV	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - CMA SLEEP CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213CW	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FHC PRENATAL CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213CX	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - PEDI NEPHROLOGY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213CY	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric Ophthalmology	903 W Martin St	San Antonio	TX	Active
DSH450213CZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Sonogram	903 W Martin St	San Antonio	TX	Active
DSH450213DA	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Mammography	903 W Martin St	San Antonio	TX	Active
DSH450213DB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Women's Behavioral Health	903 W Martin St	San Antonio	TX	Active
DSH450213DC	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA BEHAVIORAL THERAPY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DD	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA BODY IN MOTION	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DE	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Family Medicine	903 W Martin St	San Antonio	TX	Active
DSH450213DF	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - EMC NURSE TRIAGE	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DG	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Gastroenterology	903 W Martin St	San Antonio	TX	Active
DSH450213DH	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FHC LUMPS AND BUMPS	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FHC NURSE CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DK	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - GERIATRICS CONSULT CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Gynecology Oncology	903 W Martin St	San Antonio	TX	Active
DSH450213DM	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - NEUROLOGY ADULT	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Ultrasound Imaging	903 W Martin St	San Antonio	TX	Active
DSH450213DP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Podiatry - University Medicine Associates	701 S Zarzamora St	San Antonio	TX	Active
DSH450213DQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - CMA PEDI HEMATOLOGY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DR	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - CMA PEDIATRIC PSYCHIATRY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DS	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - MEDICINE FACULTY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DT	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - OB DIABETIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DU	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Lab	903 W Martin St	San Antonio	TX	Active
DSH450213DV	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric Orthopedics	903 W Martin St	San Antonio	TX	Active
DSH450213DW	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - CMA PEDI ENDOCRINOLOGY	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213DX	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - DIABETES TREATMENT CENTER	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213DY	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - CERVICAL DYSPLASIA	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213DZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA GEN PEDI NURSE CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EA	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA FFACTS MENTAL HEALTH	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus General Medicine	903 W Martin St	San Antonio	TX	Active
DSH450213EC	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - HEPATITIS NURSE CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213ED	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - I.S. NURSE CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EE	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - IS PSYCHIATRY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EF	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - NUTRITION CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EG	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - PANCREATIC CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EH	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Rheumatology	903 W Martin St	San Antonio	TX	Active
DSH450213EJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - CMA INT MED/PEDI	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213EK	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute X-Ray Imaging	701 S Zarzamora St	San Antonio	TX	Active
DSH450213EL	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA CHF TRANSITION OF CARE	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EM	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA MOONLIGHTING	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Speech Therapy	903 W Martin St	San Antonio	TX	Active
DSH450213EP	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FHCPHARMACOTHERAPY CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - OP PARENTERAL ANTIBIOTIC TH	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213ER	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - RESIDENT CONTINUTITY CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213ES	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Pulmonary	1055 Ada St	San Antonio	TX	ToBeTerminated
DSH450213ET	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - CMA TELE ENDOCRINE CONSULT	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213EU	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - VASCULAR CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EV	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - PHOTOTHERAPY	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213EW	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FHC HEALTH STEPS	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EX	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - GENERAL MEDICINE CL/SARS	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EY	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - HYPERTENSION	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213EZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - MS ADULT MEDICINE CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213F	Child	DSH	UNIVERSITY HEALTH SYSTEM	CLINIC CORRECTIONAL	200 N Comal	San Antonio	TX	Active
DSH450213FA	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Med Therapy	903 W Martin St	San Antonio	TX	Active
DSH450213FB	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - OB DIABETIC TEACHING CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FC	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pulmonology Function	903 W Martin St	San Antonio	TX	Active
DSH450213FD	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - SLEEP MEDICINE PEDI	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FE	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - NURSE INTERVENTION	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213FF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Renal	701 S ZARZAMORA ST	SAN ANTONIO	TX	Active
DSH450213FG	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - GENETICS GYN	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FH	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - HEPATITIS CHART CHECK	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Social Work	903 W Martin St	San Antonio	TX	Terminated
DSH450213FK	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - MATERNAL FETAL MEDICINE	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric Gastroenterology	903 W Martin St	San Antonio	TX	Active
DSH450213FM	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - CMA NEWLY DIAG DIABETES CLI	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213FN	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - ENHANCED NUTRITION ED	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213FP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Lab	701 S Zarzamora St	San Antonio	TX	Active
DSH450213FQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FAMILY HEALTH APC GROUP	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FR	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Physical Therapy	701 S Zarzamora St	San Antonio	TX	Active
DSH450213FS	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FHC VASECTOMY CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FT	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - PEDI CYSTIC FIBROSIS CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FU	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Hepatology	903 W Martin St	San Antonio	TX	Active
DSH450213FV	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - UMA PEDI WELLNESS WEIGHT MG	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213FW	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric Immunology and Rheumatology	903 W Martin St	San Antonio	TX	Active
DSH450213FX	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - AMBULATORY CONNECTIONS	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213FY	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - RBG CYSTO CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213FZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - ENDOCRINOLOGY/INFERTILITY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GA	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Thoracic Medicine	903 W Martin St	San Antonio	TX	Active
DSH450213GB	Child	DSH	UNIVERSITY HEALTH SYSTEM	SEIZURE CLINIC	4502 MEDICAL DRIVE	SAN ANTONIO	TX	Terminated
DSH450213GC	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Anticoagulation	903 W Martin St	San Antonio	TX	Active
DSH450213GD	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - ACUTE CARE RECHECK CLINIC	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213GE	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - PEDI BEHAVIORAL THERAPY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric ExpressMed	903 W Martin St	San Antonio	TX	Active
DSH450213GG	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - MULTIPLE SCLEROSIS CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GH	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric Urology	903 W Martin St	San Antonio	TX	Active
DSH450213GJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA FFACTS MID LEVEL CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GK	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - CMA PEDI FACULTY CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Hearing & Balance	903 W Martin St	San Antonio	TX	Active
DSH450213GM	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - I.S. DISCHARGE CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GN	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - HOSPITAL DISCHARGE	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GP	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - FHC COLPOSCOPY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - PEDI LIVER CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GR	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - DIET COUNSELING	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213GS	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Family Medicine	701 S Zarzamora St	San Antonio	TX	Active
DSH450213GT	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - GYNECOLOGY A	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GU	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - GASTROENTEROLOGY	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GV	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - OBSTETRICS A	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GW	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS RBG CAMPUS - GYNECOLOGY B	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213GX	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SFL - SFC FAMILY MEDICINE	7902 S. FLORES	SAN ANTONIO	TX	Terminated
DSH450213GY	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - WOMEN'S HEALTH NURSE CLINIC	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213GZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - DIABETES EDUCATION	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213H	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus FFACTS	903 W Martin St	San Antonio	TX	Active
DSH450213HA	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - DIABETES EDUCATION	7726 LOUIS PASTEUR	SAN ANTONIO	TX	Terminated
DSH450213HB	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - SAME DAY CLINIC	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213HC	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SFL - SFC NURSE CLINIC	7902 S. FLORES	SAN ANTONIO	TX	Terminated
DSH450213HD	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT PAV - PEDIATRIC BEHAVIOR HEALTH	4647 MEDICAL DR	SAN ANTONIO	TX	Terminated
DSH450213HE	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT PAV - PALLIATIVE CARE	4647 MEDICAL DR	SAN ANTONIO	TX	Terminated
DSH450213HF	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - SOUTHWEST HEALTH CENTER	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213HG	Child	DSH	UNIVERSITY HEALTH SYSTEM	Huebner Hearing and Balance	9618 Huebner Rd	SAN ANTONIO	TX	Active
DSH450213HH	Child	DSH	UNIVERSITY HEALTH SYSTEM	Naco Perrin Children's Health	4020 Naco Perrin Blvd	San Antonio	TX	Active
DSH450213HJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Family Medicine	1055 Ada St	San Antonio	TX	Active
DSH450213HK	Child	DSH	UNIVERSITY HEALTH SYSTEM	Zarzamora Children's Health	4503 S Zarzamora St	San Antonio	TX	Active
DSH450213HL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest Behavioral Health	2121 SW 36th St	San Antonio	TX	Active
DSH450213HM	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT KENW - KWC LVN CLINIC	302 DORA	SAN ANTONIO	TX	Terminated
DSH450213HN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Westgate Women's Health	5282 Medical Dr	San Antonio	TX	Active
DSH450213HP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast X-Ray Imaging	1055 ADA ST	SAN ANTONIO	TX	Active
DSH450213HQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT KENW - KWC NURSE CLINIC	302 DORA	SAN ANTONIO	TX	Terminated
DSH450213HR	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kenwood Women's Health	302 Dora St	San Antonio	TX	Active
DSH450213HS	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kenwood Children's Health	302 Dora St	San Antonio	TX	Active
DSH450213HT	Child	DSH	UNIVERSITY HEALTH SYSTEM	Oakwell Rheumatology	14615 San Pedro Ave	SAN ANTONIO	TX	Active
DSH450213HU	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - CMA TELEMED OPHTHALMOLGY	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213HV	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - DIABETES EDUCATION	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213HW	Child	DSH	UNIVERSITY HEALTH SYSTEM	North X-Ray	302 W Rector St	San Antonio	TX	Active
DSH450213HX	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - NURSE ADMIN CLINIC	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213HY	Child	DSH	UNIVERSITY HEALTH SYSTEM	North Children's Health	302 W Rector St	San Antonio	TX	Active
DSH450213HZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	North Med Therapy	302 W Rector St	San Antonio	TX	Terminated
DSH450213J	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Dialysis	701 S Zarzamora St	San Antonio	TX	Active
DSH450213JA	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest Med Therapy	2121 SW 36th St	San Antonio	TX	Active
DSH450213JB	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - PATIENT EDUCATION CLINIC	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213JC	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Occupational Therapy	4647 Medical Dr	San Antonio	TX	Active
DSH450213JD	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - NURSE ADMINISTRATION CLN	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213JE	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Med Therapy	701 S Zarzamora St	San Antonio	TX	Active
DSH450213JF	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - TELEMEDICINE OPHTH	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213JG	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT N-P - NPC RN CLINIC	4020 NACO PERRIN BLVD	SAN ANTONIO	TX	Terminated
DSH450213JH	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - NURSE CLINIC	7726 LOUIS PASTEUR	SAN ANTONIO	TX	Terminated
DSH450213JJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Naco Perrin Women's Health	4020 Naco Perrin Blvd	San Antonio	TX	Active
DSH450213JK	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SFL - SFC LVN CLINIC	7902 S. FLORES	SAN ANTONIO	TX	Terminated
DSH450213JL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Nephrology	1055 Ada St	San Antonio	TX	Active
DSH450213JM	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - RAD-XRAY	7726 LOUIS PASTEUR	SAN ANTONIO	TX	Terminated
DSH450213JN	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT N-P - NPC NONBILL NURSE CLINIC	4020 NACO PERRIN BLVD	SAN ANTONIO	TX	Terminated
DSH450213JP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest Children's Health	2121 SW 36th St	San Antonio	TX	Active
DSH450213JQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest X-Ray Imaging	2121 SW 36th St	San Antonio	TX	Active
DSH450213JR	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Physical Therapy	4647 MEDICAL DR	SAN ANTONIO	TX	Active
DSH450213JS	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Radiology Xray	4647 Medical Dr	San Antonio	TX	Active
DSH450213JT	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Radiology Ultrasound	4647 Medical Dr	San Antonio	TX	Active
DSH450213JU	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT N-P - NPC LVN CLINIC	4020 NACO PERRIN BLVD	SAN ANTONIO	TX	Terminated
DSH450213JV	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - PHONE INTERACTION	7726 LOUIS PASTEUR	SAN ANTONIO	TX	Terminated
DSH450213JW	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - PHONE INTERACTION	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213JX	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT PAV - CMA MOONLIGHTING	4647 MEDICAL DR	SAN ANTONIO	TX	Terminated
DSH450213JY	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Med Therapy	1055 Ada St	San Antonio	TX	Active
DSH450213JZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kennedy Family Medicine	1831 S General McMullen Dr	San Antonio	TX	Active
DSH450213K	Child	DSH	UNIVERSITY HEALTH SYSTEM	Breast Center	8403 Wurzbach Rd	San Antonio	TX	Active
DSH450213KA	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - ZAR LVN CLINIC	4503 S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213KB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kennedy Women's Health	1831 S General McMullen Dr	San Antonio	TX	Active
DSH450213KC	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SAL - RSC CMA MOONLIGHTING	630 S. GENERAL MCMULLEN	SAN ANTONIO	TX	Terminated
DSH450213KD	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - CMA MOONLIGHTING	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213KE	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - CMA BEHAVIORAL HEALTH	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213KF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Lab	1055 Ada St	San Antonio	TX	Active
DSH450213KG	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Behavioral Health	1055 ADA ST	SAN ANTONIO	TX	Active
DSH450213KH	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - CMA MOONLIGHTING	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213KJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Med Therapy	4647 Medical Dr	San Antonio	TX	Terminated
DSH450213KK	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - NURSE ADMINISTRATION	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213KL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Rheumatology	1055 ADA ST	SAN ANTONIO	TX	Active
DSH450213KM	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Children's Health	1055 Ada St	San Antonio	TX	Active
DSH450213KN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Physical Therapy	1055 ADA ST	SAN ANTONIO	TX	Active
DSH450213KP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kennedy Children's Health	1831 S General McMullen Dr	San Antonio	TX	Active
DSH450213KQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	North Behavioral Health	302 W Rector St	San Antonio	TX	Active
DSH450213KR	Child	DSH	UNIVERSITY HEALTH SYSTEM	Zarzamora Women's Health	4503 S Zarzamora St	San Antonio	TX	Active
DSH450213KS	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - PATIENT EDUCATION CLINIC	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213KT	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - ANTICOAGULATION	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213KU	Child	DSH	UNIVERSITY HEALTH SYSTEM	Westgate Sonogram	5282 Medical Dr	San Antonio	TX	Active
DSH450213KV	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SAL - RSC NURSE CLINIC	630 S. GENERAL MCMULLEN	SAN ANTONIO	TX	Terminated
DSH450213KW	Child	DSH	UNIVERSITY HEALTH SYSTEM	Westgate Endocrine	5282 Medical Drive	SAN ANTONIO	TX	Terminated
DSH450213KX	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - TELEMEDICINE OPHTH	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213KY	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southwest Lab	2121 SW 36th St	San Antonio	TX	Active
DSH450213KZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	South Flores Clinic OB/GYN	600 E Amber St	SAN ANTONIO	TX	Active
DSH450213L	Child	DSH	UNIVERSITY HEALTH SYSTEM	Surgery Center at the MARC Cardiology	8300 Floyd Curl Dr	San Antonio	TX	Active
DSH450213LA	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT PAV - UMA PEDI EXPRESS MOONLIGHT	4647 MEDICAL DR	SAN ANTONIO	TX	Terminated
DSH450213LB	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - ZAR NURSE CLINIC	4503 S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213LC	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SAL - RSC LVN CLINIC	630 S. GENERAL MCMULLEN	SAN ANTONIO	TX	Terminated
DSH450213LD	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - NW-CHART CHECK	7726 LOUIS PASTEUR	SAN ANTONIO	TX	Terminated
DSH450213LE	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - NUTRITION CLINIC	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213LF	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT PAV - CMA NURSE ADMIN. CLINIC	4647 MEDICAL DR	SAN ANTONIO	TX	Terminated
DSH450213LG	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - ZAR NONBILL NURSE CLINIC	4503 S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213LH	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - PEDI BEHAVIORAL THERAPY	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213LJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - PROCEDURE CLINIC	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213LK	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT PAV - CMA PEDI EXPRESS NAIP	4647 MEDICAL DR	SAN ANTONIO	TX	Terminated
DSH450213LL	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - PHONE INTERACTION	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213LM	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SFL - SFC OB CLINIC	7902 S. FLORES	SAN ANTONIO	TX	Terminated
DSH450213LN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatrics	903 W Martin St	San Antonio	TX	Active
DSH450213LP	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - CMA PEDI RESIDENT ACUTE CLI	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213LQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	North NICU Grad	302 W Rector St	San Antonio	TX	Active
DSH450213LR	Child	DSH	UNIVERSITY HEALTH SYSTEM	Hilliard Med Therapy	919 Locke St	San Antonio	TX	Terminated
DSH450213LS	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - ZAR CMA MOONLIGHTING	4503 S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213LT	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - FAMILY PLANNING PROJECT	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213LU	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - PHARM D CLINIC	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213LV	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - UMA PEDIATRIC DEV SPECIAL	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213LW	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Speech Therapy	4647 Medical Dr	San Antonio	TX	Active
DSH450213LX	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Endocrinology Fellows	701 S ZARZAMORA ST	SAN ANTONIO	TX	Active
DSH450213LY	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatric Pulmonology Function	903 W Martin St	San Antonio	TX	Active
DSH450213LZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - CMA MOONLIGHTING PEDI EXPR	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213MA	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT NORT - FAMILY PRACTICE	302 W. RECTOR	SAN ANTONIO	TX	Terminated
DSH450213MB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Physical Therapy	903 W Martin St	San Antonio	TX	Active
DSH450213MC	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT N-P - PATIENT COMMUNICATION	4020 NACO PERRIN BLVD	SAN ANTONIO	TX	Terminated
DSH450213MD	Child	DSH	UNIVERSITY HEALTH SYSTEM	Shirley A. Schreiber Clinic NISD	1256 Pinn Rd	San Antonio	TX	Active
DSH450213ME	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - UMA PEDI WELLNESS WEIGHT MA	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213MF	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT PAV - UMA PEDIATRIC DEV SPECIAL	4647 MEDICAL DR	SAN ANTONIO	TX	Terminated
DSH450213MG	Child	DSH	UNIVERSITY HEALTH SYSTEM	PROCTOLOGY CLN	903 W. Martin Street	SAN ANTONIO	TX	Terminated
DSH450213MH	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Teen Health	903 W Martin St	San Antonio	TX	Active
DSH450213MJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SE - CMA NURSE MED SCREEN	1055 ADA ST	SAN ANTONIO	TX	Terminated
DSH450213MK	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - UMA SPECIALTY CLINIC	701S ZARZAMORA ST	SAN ANTONIO	TX	Terminated
DSH450213ML	Child	DSH	UNIVERSITY HEALTH SYSTEM	Westgate Children's Health	5282 Medical Dr	San Antonio	TX	Active
DSH450213MM	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - PHONE INTERACTION	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213MN	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - UMA SPECIALTY CLINIC	2121 SW 36TH STREET	SAN ANTONIO	TX	Terminated
DSH450213MP	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - NON STRESS TEST-NST	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213MQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Neurology	1055 Ada St	San Antonio	TX	Active
DSH450213MR	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - ADULT ALLERGY CLINIC	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213MS	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT - UMA CENTER GRP PREG OBGYN	903 WEST MARTIN	SAN ANTONIO	TX	Terminated
DSH450213MT	Child	DSH	UNIVERSITY HEALTH SYSTEM	Hilliard Family Medicine	919 Locke St	San Antonio	TX	Active
DSH450213MU	Child	DSH	UNIVERSITY HEALTH SYSTEM	Advanced Endoscopy at Mays	7979 Wurzbach Rd	San Antonio	TX	Active
DSH450213MV	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT SFL - SFC CMA MOONLIGHTING	7902 S. FLORES	SAN ANTONIO	TX	Terminated
DSH450213MW	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - MEDICINE/WOMANS HEALTH CL.	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213MX	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - UMA MOBILE UNIT MOONLIGHT	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213MY	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - MOBILE SCHOOL PROGRAM CMA	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213MZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	UNIVERSITY HOSPITAL - UMA PEDI RESPITE	4502 MEDICAL DRIVE	SAN ANTONIO	TX	Terminated
DSH450213N	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus CT Imaging	903 W Martin St	San Antonio	TX	Active
DSH450213NA	Child	DSH	UNIVERSITY HEALTH SYSTEM	UHS DR. ROBERT HILLIARD CENTER - UMA HILLIARD ENDO	919 LOCKE ST	SAN ANTONIO	TX	Terminated
DSH450213NB	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - MOMMIES CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213NC	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Cardiac Rehab	903 W Martin St	San Antonio	TX	Active
DSH450213ND	Child	DSH	UNIVERSITY HEALTH SYSTEM	South Flores Children's Health	600 E Amber St	San Antonio	TX	Active
DSH450213NE	Child	DSH	UNIVERSITY HEALTH SYSTEM	BEXAR COUNTY HOSPITAL DISTRICT RBG - DME FOLLOW UP CLINIC	903W MARTIN ST	SAN ANTONIO	TX	Terminated
DSH450213NF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Huebner Family Medicine	11703 Huebner Rd	San Antonio	TX	Active
DSH450213NG	Child	DSH	UNIVERSITY HEALTH SYSTEM	Inwood Family Medicine	15102 Huebner Rd	San Antonio	TX	Active
DSH450213NH	Child	DSH	UNIVERSITY HEALTH SYSTEM	Warm Springs Pain	5101 Medical Dr.	San Antonio	TX	Active
DSH450213NJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Davis School-Based Clinic SAISD	4702 E Houston St	San Antonio	TX	Active
DSH450213NK	Child	DSH	UNIVERSITY HEALTH SYSTEM	Tafolla School-Based Clinic SAISD	1303 W Cesar E Chavez Blvd	San Antonio	TX	Active
DSH450213NL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Dominion Crossing Family Medicine	21727 IH 10 West	San Antonio	TX	Active
DSH450213NM	Child	DSH	UNIVERSITY HEALTH SYSTEM	Dominion Crossing - Endocrinology	21727 IH 10 West	San Antonio	TX	ToBeTerminated
DSH450213NN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Luckey Ranch X-Ray Imaging	11930 W US Highway 90	San Antonio	TX	Active
DSH450213NP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Dominion Crossing Cardiology	21727 IH 10 West	San Antonio	TX	Active
DSH450213NQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Hilliard Sleep Medicine	919 Locke St	San Antonio	TX	Active
DSH450213NR	Child	DSH	UNIVERSITY HEALTH SYSTEM	Oakwell Neurology	3338 Oakwell Ct	San Antonio	TX	ToBeTerminated
DSH450213NS	Child	DSH	UNIVERSITY HEALTH SYSTEM	Luckey Ranch ExpressMed	11930 W US Highway 90	San Antonio	TX	Active
DSH450213NT	Child	DSH	UNIVERSITY HEALTH SYSTEM	Hilliard Women's Health	919 Locke St	San Antonio	TX	Active
DSH450213NU	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Anesthesia Pre-Op	4647 Medical Dr	San Antonio	TX	Active
DSH450213NV	Child	DSH	UNIVERSITY HEALTH SYSTEM	Edgewood Pediatric Development - Developmental and Behavioral Pediatrics	911 Enrique M Barrera	San Antonio	TX	Terminated
DSH450213NW	Child	DSH	UNIVERSITY HEALTH SYSTEM	Hilliard Pediatrics	919 Locke St	San Antonio	TX	Active
DSH450213NX	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Teen Behavioral Health	903 W Martin St	San Antonio	TX	Active
DSH450213NY	Child	DSH	UNIVERSITY HEALTH SYSTEM	Warm Springs Rehabilitation Medicine	5101 Medical Dr	San Antonio	TX	Active
DSH450213NZ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pavilion Lab	4647 Medical Dr	San Antonio	TX	ToBeTerminated
DSH450213P	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Family Medicine	903 W Martin St	San Antonio	TX	Active
DSH450213PA	Child	DSH	UNIVERSITY HEALTH SYSTEM	Huebner Pediatrics Ear, Nose, And Throat	9618 Huebner Rd	San Antonio	TX	Active
DSH450213PB	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Infusion Center	1055 Ada St	San Antonio	TX	Active
DSH450213PC	Child	DSH	UNIVERSITY HEALTH SYSTEM	Dialysis Medical Center	6146 Wurzbach Rd	San Antonio	TX	Active
DSH450213PD	Child	DSH	UNIVERSITY HEALTH SYSTEM	Converse Family Medicine Clinic	8455 Crestway Rd	Converse	TX	Active
DSH450213PE	Child	DSH	UNIVERSITY HEALTH SYSTEM	Oakwell Sleep Medicine	3338 Oakwell Ct	San Antonio	TX	Active
DSH450213PF	Child	DSH	UNIVERSITY HEALTH SYSTEM	Oakwell Pulmonology Function	3338 Oakwell Ct	San Antonio	TX	Active
DSH450213PG	Child	DSH	UNIVERSITY HEALTH SYSTEM	Southeast Oncology	1055 Ada St	San Antonio	TX	ToBeTerminated
DSH450213PH	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Pediatrics - RBG PEDI CONTINUITY	903 W Martin St	San Antonio	TX	Active
DSH450213PJ	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Infectious Disease - Infectious Diseases	903 W Martin St	San Antonio	TX	Active
DSH450213PK	Child	DSH	UNIVERSITY HEALTH SYSTEM	Tumor Center at Mays - General Surgery	7979 Wurzbach Rd	San Antonio	TX	ToBeTerminated
DSH450213PL	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Cardiology - Cardiology	701 S Zarzamora st	San Antonio	TX	Active
DSH450213PM	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Respiratory Services - Pulmonology	903 W Martin St	San Antonio	TX	Active
DSH450213PN	Child	DSH	UNIVERSITY HEALTH SYSTEM	Pancreas Tumor at Mays - General Surgery	7979 Wurzbach RD	San Antonio	TX	ToBeTerminated
DSH450213PP	Child	DSH	UNIVERSITY HEALTH SYSTEM	Collier Pediatric Diabetes Clinic - Pediatric Endocrinology	834 W Southcross Blvd	San Antonio	TX	Active
DSH450213PQ	Child	DSH	UNIVERSITY HEALTH SYSTEM	North Rheumatology - Rheumatology	302 W Rector St	San Antonio	TX	ToBeTerminated
DSH450213PR	Child	DSH	UNIVERSITY HEALTH SYSTEM	North Endocrinology - Endocrinology	302 W Rector St	San Antonio	TX	ToBeTerminated
DSH450213PS	Child	DSH	UNIVERSITY HEALTH SYSTEM	Hilliard Sonogram - Obstetrics & Gynecology	919 Locke St	San Antonio	TX	Active
DSH450213PT	Child	DSH	UNIVERSITY HEALTH SYSTEM	Liver Tumor at Mays - General Surgery	7979 Wurzbach RD	San Antonio	TX	ToBeTerminated
DSH450213PU	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Ophthalmology - Optometry	701 S Zarzamora st	San Antonio	TX	Active
DSH450213PV	Child	DSH	UNIVERSITY HEALTH SYSTEM	Inwood Neurology - Neurology	15102 Huebner Rd	San Antonio	TX	ToBeTerminated
DSH450213PW	Child	DSH	UNIVERSITY HEALTH SYSTEM	Kennedy NICU Grad - Pediatrics	1831 S General McMullen Dr	San Antonio	TX	Active
DSH450213Q	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Cardiology	903 W Martin St	San Antonio	TX	Active
DSH450213R	Child	DSH	UNIVERSITY HEALTH SYSTEM	Medicine Clinic	903 West Martin	San Antonio	TX	Terminated
DSH450213S	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus MR Imaging	903 W Martin St	San Antonio	TX	Active
DSH450213T	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Diagnostic Cardiology	903 W Martin St	San Antonio	TX	Active
DSH450213U	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Women's Health	903 W Martin St	San Antonio	TX	Active
DSH450213W	Child	DSH	UNIVERSITY HEALTH SYSTEM	Robert B. Green Campus Respiratory	903 W Martin St	San Antonio	TX	Active
DSH450213X	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Pediatric Diabetes Clinic	701 S Zarzamora St	San Antonio	TX	Active
DSH450213Y	Child	DSH	UNIVERSITY HEALTH SYSTEM	Renal/Derm Clinic	701 South Zarzamora	San Antonio	TX	Terminated
DSH450213Z	Child	DSH	UNIVERSITY HEALTH SYSTEM	Texas Diabetes Institute Hyperbarics And Wound Care	701 S Zarzamora St	San Antonio	TX	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Hurley, Reed Sr. Vice President/CFO University Health System 2103582101-2141	Hurley, Reed Executive Vice President/CFO University Health System 2103582101-2141	10/6/2023 8:10 AM
Contacts	Signed By	Update	Profile Change Request	Hurley, Reed Sr. Vice President/CFO University Health System 2103582101-2141	Hurley, Reed Executive Vice President/CFO University Health System 2103582101-2141	10/6/2023 8:10 AM
Details	State	Update		To Be Terminated	Terminated	10/1/2023 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		8/1/2023 12:00:00 AM	8/29/2023 6:00 PM
Details	State	Update	Recertification	Active	To Be Terminated	8/29/2023 6:00 PM
Terminations	Termination Comments	Update	Recertification		regrouping of services/departments to align with our electronic health record (EHR)	8/29/2023 6:00 PM
Terminations	Termination Date	Update	Recertification		10/1/2023 12:00:00 AM	8/29/2023 6:00 PM
Terminations	Termination Effective Date	Update	Recertification		8/1/2023 12:00:00 AM	8/29/2023 6:00 PM
Terminations	Termination Reason	Update	Recertification		Other	8/29/2023 6:00 PM
Details	Last Recertification Date	Update	Recertification	8/23/2021 9:48:29 AM	8/31/2022 2:30:35 PM	8/31/2022 2:30 PM
Contacts	Primary Contact	Update	Profile Change Request	Benedetti, Josefa Assistant Director of Pharmacy, Business & Technology University Health System 2107434077	Benedetti, Josefa Executive Director of Pharmacy University Health System 2107434077	11/11/2021 1:33 PM
Details	Last Recertification Date	Update	Recertification	8/24/2020 5:47:34 PM	8/23/2021 9:48:29 AM	8/23/2021 9:48 AM
Contacts	Authorizing Official	Update	Profile Change Request	Hurley, Reed Sr. Vice President/CRO University Health System 2103582101	Hurley, Reed Sr. Vice President/CFO University Health System 2103582101-2141	8/9/2021 12:19 PM
Contacts	Signed By	Update	Profile Change Request	Hurley, Reed Sr. Vice President/CRO University Health System 2103582101	Hurley, Reed Sr. Vice President/CFO University Health System 2103582101-2141	8/9/2021 12:19 PM
Contacts	Primary Contact	Update	Group Change Request	Palacios, Javier Palacios Director of Pharmacy University Health System 2103582896	Benedetti, Josefa Assistant Director of Pharmacy, Business & Technology University Health System 2107434077	8/3/2021 9:32 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		250252	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		250387	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		250372	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		250182	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		250478	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		144902	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		146578	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		110066561B	8/24/2020 5:47 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		MA	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1851499453	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1164533816	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1922119668	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1235240979	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1336243054	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1265536973	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1538445861	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1447320841	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1811320948	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1336353309	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1700908506	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1821011248	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		TX	8/24/2020 5:47 PM
Medicaid Billing	NPI: State	Update	Recertification		MA	8/24/2020 5:47 PM
Details	Last Recertification Date	Update	Recertification	8/20/2019 2:43:42 PM	8/24/2020 5:47:34 PM	8/24/2020 5:47 PM
Details	Last Recertification Date	Update	Recertification	8/16/2018 4:11:55 PM	8/20/2019 2:43:42 PM	8/20/2019 2:43 PM
Details	Last Recertification Date	Update	Recertification		8/16/2018 4:11:55 PM	8/16/2018 4:11 PM
Contacts	Primary Contact	Update	New Registration	Palacios, Javier Director of Pharmacy University Health System 2103582896	Palacios, Javier Palacios Director of Pharmacy University Health System 2103582896	7/3/2018 10:52 AM
Details	State	Update		Approved	Active	4/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		Hurley, Reed Sr. Vice President/CRO University Health System 2103582101	1/23/2018 1:48 PM
Details	340B ID	Update	New Registration		DSH450213EV	1/23/2018 1:48 PM
Details	Entity Subname	Update	New Registration	BEXAR COUNTY HOSPITAL DISTRICT	BEXAR COUNTY HOSPITAL DISTRICT - PHOTOTHERAPY	1/23/2018 1:48 PM
Dates	Participating Approval Date	Update	New Registration		1/23/2018 1:48:04 PM	1/23/2018 1:48 PM
Details	State	Update	New Registration	Pending	Approved	1/23/2018 1:48 PM
Dates	Signed By Date	Update	New Registration		1/14/2018 12:16:26 PM	1/23/2018 1:48 PM
Dates	Start Date	Update	New Registration		4/1/2018 12:00:00 AM	1/23/2018 1:48 PM
Addresses	Main Address	Insert	New Registration		701S ZARZAMORA ST UNIVERSITY CENTER FOR COMMUNITY HEALTH SAN ANTONIO, TX 78207-5209	1/12/2018 7:41 PM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/12/2018 7:41 PM
Medicaid Billing	Medicaid: Number	Insert	New Registration		136141205	1/12/2018 7:41 PM
Medicaid Billing	Medicaid: State	Insert	New Registration		TX	1/12/2018 7:41 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1821011248	1/12/2018 7:41 PM
Contacts	Primary Contact	Insert	New Registration		Palacios, Javier Director of Pharmacy University Health System 2103582896	1/12/2018 7:41 PM
Contacts	Authorizing Official	Insert	New Registration		Hurley, Reed Sr. Vice President/CRO University Health System 2103582101	1/12/2018 7:41 PM
Details	Last Recertification Date	Insert	New Registration			1/12/2018 7:41 PM
Details	Grant Number	Insert	New Registration			1/12/2018 7:41 PM
Details	340B ID	Insert	New Registration			1/12/2018 7:41 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/12/2018 7:41 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/12/2018 7:41 PM
Details	Medicare Provider Number	Insert	New Registration		450213	1/12/2018 7:41 PM
Details	Entity Name	Insert	New Registration		UNIVERSITY HEALTH SYSTEM	1/12/2018 7:41 PM
Details	Program Code	Insert	New Registration		DSH	1/12/2018 7:41 PM
Details	Entity Subname	Insert	New Registration		BEXAR COUNTY HOSPITAL DISTRICT	1/12/2018 7:41 PM
Dates	Participating Approval Date	Insert	New Registration			1/12/2018 7:41 PM
Details	State	Insert	New Registration		Pending	1/12/2018 7:41 PM
Dates	Registration Date	Insert	New Registration		1/12/2018 7:41:36 PM	1/12/2018 7:41 PM
Dates	Signed By Date	Insert	New Registration			1/12/2018 7:41 PM
Dates	Start Date	Insert	New Registration			1/12/2018 7:41 PM
Terminations	Termination Comments	Insert	New Registration			1/12/2018 7:41 PM
Terminations	Termination Date	Insert	New Registration			1/12/2018 7:41 PM
Terminations	Termination Effective Date	Insert	New Registration			1/12/2018 7:41 PM
Terminations	Termination Reason	Insert	New Registration			1/12/2018 7:41 PM