Provider First Line Business Practice Location Address:
1005 HARBORSIDE DRIVE
Provider Second Line Business Practice Location Address:
UNIVERSITY HOSPITAL CLINICS (UHC) 6TH FLOOR
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77555-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-772-0644
Provider Business Practice Location Address Fax Number:
409-747-0777
Provider Enumeration Date:
09/11/2026