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General NPI Number Information
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NPI Number | 1982808549
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Entity Type | Individual
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Provider Name | ANN KATHLEEN NOBLEJAS GAMILLA-CRUDO MD
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Gender | Female
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD 4.200 JOHN SEALY ANNEX
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City | GALVESTON
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State | TX
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Zip | 77555-0562
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Country | US
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Telephone | 409-772-1811
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Fax | 409-772-5052
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Provider Business Mailing Address
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Address Line | 3433 COVE VIEW BLVD #2308
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City | GALVESTON
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State | TX
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Zip | 77554-8175
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Country | US
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Telephone | 409-877-2814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | BP1-0026290
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License Number State | TX
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