UTMB (NPI# 1063821981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063821981 |
| Entity Type | Organization |
| Organization Name | UTMB |
| Practice Address |
12603 Southwest Fwy Ste 335 Stafford TX 77477-3842 |
| Practice Telephone | 2812696700 |
| Practice Fax Number | 2812655163 |
| Mailing Telephone | 2812696700 |
| Mailing Fax Number | 2812655163 |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |
| Authorized Official Name | MS. SANDRA K SMOCK (PROVIDER) |
| Authorized Official Telephone | 2812696700 |
| Authorized Official Credential | APN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2400X |
Clinic/Center Specialization: Prison Health |
233196 | TX | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831318781 | Utmb | Special Hospital | 515 1st St, #330, Galveston, TX 77550-5769 | 2007-04-25 |
| 1295281350 | Utmb | Clinic/Center | 301 University Blvd, Galveston, TX 77555-5302 | 2016-08-29 |
| 1497105084 | Utmb | Nurse Practitioner | 3060 Fm 3514, Medical Department - Ms. Adodo, Beaumont, TX 77705-7635 | 2016-06-15 |
| 1811394208 | Utmb | Point of Service | 2350 Atascocita Rd, Humble, TX 77396-3503 | 2014-12-01 |
| 1568869063 | Utmb | General Acute Care Hospital | 301 University Blvd, Galveston, TX 77555-0587 | 2014-11-26 |
| 1487059077 | Utmb | Health Maintenance Organization | 1500 E Langdon Rd, Dallas, TX 75241-7136 | 2014-10-27 |
| 1386923670 | Utmb | General Acute Care Hospital | 301 University Blvd, Jsa 9.128. Dept of Neurology, Galveston, TX 77555-0539 | 2011-08-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UTMB | 301 University Blvd, Galveston, TX 77555-5302 |
| Street Address |
12603 SOUTHWEST FWY STE 335 |
| City | STAFFORD |
| State | TX |
| Zip Code | 77477-3842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336371582 | Rosalynn Nelson | Psychiatry & Neurology | 12603 Southwest Fwy Ste 335, Stafford, TX 77477 | 2009-08-20 |
| 1801276217 | Sanadra Smock | Nurse Practitioner | 12603 Southwest Fwy Ste 335, Stafford, TX 77477-3842 | 2015-06-02 |
| 1720485212 | Michelle Lastrapes | Physician Assistant | 12603 Southwest Fwy Ste 335, Stafford, TX 77477-3842 | 2014-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851904924 | Joby George Samuel | Pharmacist | 16675 W. Airport, Meadows Place, TX 77477 | 2020-08-28 |
| 1184261851 | Butterfly Wellness, Pllc | Family Medicine | 1250 Texas Parkway Ste A1, Missouri City, TX 77477 | 2019-12-02 |
| 1013564848 | B Williams & Co | Ambulance | 435 Murphy Rd, Suite B1, #233, Stafford, TX 77477 | 2019-08-26 |
| 1033763594 | Sabrina Gonzales-smith | Behavioral Analyst | 10435 Greenbough Dr. Suite 410, Stafford, TX 77477 | 2019-08-01 |
| 1578021986 | Daniel Max & Marcandrea LLC | Optometrist | 11229 W Airport Blvd, Suite 300, Stafford, TX 77477 | 2019-03-05 |
| 1245794783 | All Peoples Choice Healthcare Services Inc | Home Health | 11707 Kenzie Ct, Meadows Place, TX 77477 | 2019-01-29 |
| 1467925867 | Sheila Densie Wiltz | Counselor | 215 Kingsway Dr., Stafford, TX 77477 | 2019-01-08 |
| 1427529312 | Bianca Gil | Behavioral Analyst | 10435 Geenbough Dr, St 410, Stafford, TX 77477 | 2018-12-17 |
| 1508349770 | Cedric Ita Eyo | Counselor | 10500 Fountain Lake Drive, Apt. 428, Stafford, TX 77477 | 2018-09-12 |
| 1386126712 | Enajite Yvonne Omezi | Registered Nurse | 3001 Dove Country Drive, Apt 1809, Stafford, TX 77477 | 2018-09-01 |
| Find all providers in zip 77477 | ||||
| Taxonomy Code | 261QP2400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Prison Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649497801 | Big Spring Correctional Center | Clinic/Center | 1701 Apron Dr, Big Spring, TX 79720-7821 | 2007-04-19 |
| 1487052452 | Harris County Sheriff's Office | Clinic/Center | 1200 Baker St, Houston, TX 77002-1206 | 2014-12-08 |
| 1992061188 | Federal Prison Camp | Clinic/Center | 1100 Ursuline Ave, Bryan, TX 77803-4951 | 2012-04-02 |
| 1447419353 | Federal Detention Center Houston | Clinic/Center | 1200 Texas Ave, Houston, TX 77002 | 2008-06-05 |
Please comment or provide details below to improve the information on UTMB.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.