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General NPI Number Information
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NPI Number | 1831318781
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Entity Type | Organization
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Legal Business Name | UTMB
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 515 1ST ST #330
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City | GALVESTON
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State | TX
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Zip | 77550-5769
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Country | US
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Telephone | 409-763-5717
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Fax | 409-763-5717
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Provider Business Mailing Address
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Address Line | 515 1ST ST #330
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City | GALVESTON
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State | TX
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Zip | 77550-5769
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Country | US
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Telephone | 409-763-5717
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Fax | 409-763-5717
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Authorized Official
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Title or Position | PHYSICALTHERAPIST
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Name | MISS JANAKI M MURUGESAN III
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Credential | BPT
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Telephone | 409-877-3543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 1081636
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License Number State | TX
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