NPIMap

Organization Active NPI

University of Texas Medical Branch at Galveston

  • Point of Service
  • Willis, TX
National Provider Identifier
1629465950
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
PA 00006 Issued in TX
Legal business name
UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Practice address
11437 Outpost Cove
Willis, TX 77318-5485
Phone
(936) 890-3287
NPI assigned
Apr 24, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Authorized official

Name
Dr. Bobby Vincent, MD
Title
Regional Medical Director
Phone
(936) 295-8200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X PA 00006 TX Primary

Addresses

Primary practice location

11437 Outpost Cove
Willis, TX 77318-5485

Mailing address

11437 Outpost Cove
Willis, TX 77318-5485
Phone (936) 890-3287

National Provider Directory

National Provider Directory
Tax ID family
Camp Cullen Child Dial Ctr19 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

NPI Registry JSON

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429833600000",
    "number": "1629465950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11437 OUTPOST COVE",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185485",
            "telephone_number": "936-890-3287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11437 OUTPOST COVE",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773185485",
            "telephone_number": "936-890-3287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2015-04-24",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "REGIONAL MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "936-295-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "TX",
            "license": "PA 00006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willis, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; 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.