Provider Demographics
NPI:1790456028
Name:UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Entity Type:Organization
Organization Name:UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOCHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REISER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-772-1909
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:RT 0115
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0115
Mailing Address - Country:US
Mailing Address - Phone:409-747-8783
Mailing Address - Fax:
Practice Address - Street 1:20740 GULF FREEWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598
Practice Address - Country:US
Practice Address - Phone:832-505-3170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336S0011XSuppliersPharmacySpecialty Pharmacy