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General NPI Number Information
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NPI Number | 1467751024
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Entity Type | Organization
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Legal Business Name | UTMB REGIONAL MATERNAL AND CHILD HEALTH
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Dates
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Enumeration Date | 03/22/2011
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 3737 RED BLUFF SUITE 150
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City | PASADENA
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State | TX
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Zip | 77502-3307
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Country | US
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Telephone | 713-473-5180
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Fax | 713-473-7160
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Provider Business Mailing Address
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Address Line | 301 UNIVERSITY BLVD. ROUTE-1078
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City | GALVESTON
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State | TX
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Zip | 77555-1078
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Country | US
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Telephone | 409-772-7725
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Fax | 409-772-7726
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Authorized Official
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Title or Position | DIRECTOR, CLINICAL SUPPORT SERVICES
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Name | LIZ CASTILLO
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Credential |
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Telephone | 409-772-7725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0005X
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Taxonomy Name | Ambulatory Family Planning Facility
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License Number |
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License Number State |
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