Organization
UTMB FACULTY GROUP PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GABRIELA VILLARREAL (DIRECTOR)
(409) 747-1173
Entity
Organization
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Mailing address
PO BOX 650859, DEPT 710, DALLAS, TX 75265-0859
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207ZP0101X
Anatomic Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0203X
Therapeutic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109372601
—
TX
01
—
CI5830
RR PIN
TX
Enumeration date
06/09/2006
Last updated
06/04/2024
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