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General NPI Number Information
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NPI Number | 1073592739
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
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Dates
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Enumeration Date | 01/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-5683
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Country | US
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Telephone | 409-772-4866
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Fax |
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Provider Business Mailing Address
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Address Line | 3433 COVE VIEW BLVD APT 3303
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City | GALVESTON
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State | TX
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Zip | 77554
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE CHAIR OF PATHOLOGY
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Name | MOHAMED ELGHETANY
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Credential |
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Telephone | 409-747-2468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number | 2002026
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License Number State |
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