Organization
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Active
Other names
University of Texas Medical Branch
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES P MOUTON MD (PRESIDENT AD INTERIM)
(409) 772-1902
Entity
Organization
Contact information
Practice address
301 UNIVERSITY BLVD, RT 1076, GALVESTON, TX 77555-1388
(409) 747-6520
(409) 747-0164
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-0115
(409) 747-8783
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085973802
—
TX
Enumeration date
04/26/2006
Last updated
09/06/2022
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