NPIMap

Organization Active NPI

University of Texas Medical Branch at Galveston

  • Ph.D. Medical Genetics
  • Galveston, TX
National Provider Identifier
1073592739
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
2002026 Issued in NU
Legal business name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Practice address
301 University Blvd
Galveston, TX 77555-5683
Phone
(409) 772-4866
NPI assigned
Jan 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mohamed Elghetany
Title
Vice Chair of Pathology
Phone
(409) 747-2468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X 2002026 NU Primary

Addresses

Primary practice location

301 University Blvd
Galveston, TX 77555-5683

Mailing address

3433 Cove View Blvd
Apt 3303
Galveston, TX 77554

Other identifiers 1

IdentifierTypeStateIssuer
CQP28231OtherNYLAB DIRECTOR CQ

National Provider Directory

National Provider Directory
Tax ID family
University of Texas Medical Branch at Galveston19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073592739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 COVE VIEW BLVD",
            "address_2": "APT 3303",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "77554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775555683",
            "telephone_number": "409-772-4866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELGHETANY",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "VICE CHAIR OF PATHOLOGY",
        "authorized_official_telephone_number": "409-747-2468"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "NU",
            "license": "2002026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LAB DIRECTOR CQ",
            "identifier": "CQP28231",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galveston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.