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General NPI Number Information
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NPI Number | 1760737803
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF TEXAS MEDICAL FOUNDATION
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Dates
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Enumeration Date | 07/15/2012
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Last Update Date | 07/15/2012
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Provider Practice Location Address
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Address Line | 6431 FANNIN ST MSB 4.331
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-500-7237
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Fax | 713-500-7213
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Provider Business Mailing Address
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Address Line | 6431 FANNIN ST MSB 4.331
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-500-7237
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Fax | 713-500-7213
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Authorized Official
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Title or Position | GENERAL SURGERY RESIDENT
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Name | DR. DAVID CHRISTEN GOCHNOUR II
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Credential | M.D.
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Telephone | 713-500-7237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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