Healthcare Provider Details

I. General information

NPI: 1386026367
Provider Name (Legal Business Name): UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 GULF FWY S PHARMACY ROOM 2.203
LEAGUE CITY TX
77573-5143
US

IV. Provider business mailing address

301 UNIVERSITY BLVD ROUTE 0115
GALVESTON TX
77555-0115
US

V. Phone/Fax

Practice location:
  • Phone: 832-505-3172
  • Fax:
Mailing address:
  • Phone: 409-747-8783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number130036
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. JOCHEN REISER
Title or Position: PRESIDENT
Credential: MD
Phone: 409-772-1909