GENERAL INFORMATION FOR CLINICAL TRIAL AGREEMENTS
(INDUSTRY-SUPPORTED STUDIES)
ADMINISTRATIVE CONTACTS
Authorized Signatory
Angela R. Charboneau Wishon, J.D.
Vice President for Research Administration
The University of Texas Southwestern Medical Center at Dallas
6363 Forest Park Road, BP9.100
Dallas, TX 75390-9105
Tel: (214) 648-0455 Fax: (214) 648-4474
Agreement Negotiation
Daniel Shusterman
Assistant Director for Research Contracts
The University of Texas Southwestern Medical Center at Dallas
6363 Forest Park Road, BP9.100
Dallas, TX 75390-9105
Tel: (214) 648-6410 Fax: (214) 648-4474
Tracey Johnson
Sr. Grants & Contracts Specialist
The University of Texas Southwestern Medical Center at Dallas
6363 Forest Park Road, BP9.100
Dallas, TX 75390-9105
Tel: (214) 648-2318 Fax: (214) 648-4474
Deborah Harris
Sr. Grants & Contracts Specialist
The University of Texas Southwestern Medical Center at Dallas
6363 Forest Park Road, BP9.100
Dallas, TX 75390-9105
Tel: (214) 648-4473 Fax: (214) 648-4474
Scott Bergener
Sr. Grants & Contracts Specialist
The University of Texas Southwestern Medical Center at Dallas
6363 Forest Park Road, BP9.100
Dallas, TX 75390-9105
Tel: (214) 648-0225 Fax: (214) 648-4474
Dustin Wood
Grants & Contracts Specialist
The University of Texas Southwestern Medical Center at Dallas
6363 Forest Park Road, BP9.100
Dallas, TX 75390-9105
Tel: (214) 648-0225 Fax: (214) 648-4474
INDIRECT COST RATE: 30%
TAX ID NUMBER: 75-6002868
LOCKBOX ADDRESS FOR RECEIPT OF CHECKS
*NOTE: Checks should be made payable to "The University of Texas Southwestern Medical Center at Dallas" and should reference the Principal Investigator's name and protocol number.
U.S. Mail:
UT Southwestern Clinical Trials
P.O. Box 842265
Dallas, TX 75284-2265
FedEx or Other Courier:
Bank of America Lockbox Services
Attn: Lockbox #842265
1950 N. Stemmons Fwy. Suite 5010
Dallas, TX 75207
1.800.376.2703 (for courier airbill)
Wire Transfer
Bank Name: Bank of America
ACH ABA Number: 111000025
Swift Code: BOFAUS3N
CHIPS: 0959
Account Name: UT Southwestern Medical Center at Dallas
Account Number: 000180794313
Bank Address: 901 Main Street, 10th Floor
Dallas, TX 75202-3714
Please reference Principal Investigator's name and Protocol number.
