Dr. Makishima received her Medical Degree (1992) and PhD in Philosophy (1998) from Kyushu University School of Medicine, Fukuoka, Japan. She completed her Residency and Clinical Fellowship at the Department Otorhinolaryngology at Kyushu University Medical Hospital in 1994, as well as her Clinical Fellowship in 1998. She is Board Certified by The Otorhinolaryngological Society of Japan. She joined UTMB in 2005.

Dr. Crystal Sierra joined UTMB Health in November 2010.  After completing her undergraduate studies at The University of Texas - Pan American in Edinburg, Texas, Dr. Sierra earned her medical degree from The University of Texas Medical Branch in Galveston in 2006. In 2009, she completed her Residency in Pediatrics at UTMB. Prior to working for UTMB, Dr. Sierra worked as a pediatrician in Clear Lake.

Dr. Sierra is board certified by The American Board of Pediatrics. She is also certified in Basic Life Support and Pediatric Advanced Life Support. She has her Texas medical license, and is a member of The American Academy of Pediatrics.

Dr. Sierra is married to Dr. James T. Sierra, a dentist in Friendswood, and they have two beautiful daughters, Gabriella and Francesca.  Dr. Sierra is fluent in Spanish and also enjoys reading and traveling with her family in her spare time.  She has enjoyed living in the area, and is excited to be giving back to the community!

Dr. Ralph W. Noble III has been a general pediatrician since 1978. He attended medical school and completed his specialty training in pediatrics at UTMB. He is certified by the American Board of Pediatrics and is a fellow of the American Academy of Pediatrics. He has taught UTMB medical students and pediatric residents throughout his career.

Dr. Noble enjoys practicing general pediatrics. He has an interest in mind/body medicine, including breathing techniques, meditation, and exercises.

In the past, Dr. Noble has served as a clinic medical director, public school medical consultant, teaching a sex education course at one of Galveston's private schools, medical director of the Advocacy Center for Children of Galveston County, a member of the board of various Galveston community agencies. For several years he was an assistant scoutmaster of a Galveston Boy Scout troop.

 Provider is LGBTQIA+ Responsive

I grew up in Clear Lake myself, so I was very excited to become a part of this UTMB Clear Lake family. I attended the University of Houston – Main Campus for my bachelor’s degree, and I completed my medical training (medical school and my pediatric residency) in the large Texas Medical Center in Houston. In 2023, I moved back to Clear Lake so that I could give back to this wonderful community.

I have a wonderful husband, and we are lucky to have both our families and fur-siblings in the area. My hobbies include playing tennis (when it’s not too hot outside), playing the piano, and spending quality time with family and friends.

Pediatrics has been my calling since high school. I am blessed to have the opportunity to be able to educate and comfort patients and their family members in some of their most stressful times. I love that I get to watch these children grow from newborns into wonderful young adults and help them along the way.

Being a growing child (or even raising one) isn’t easy! Every patient brings their own story, challenges, and personality, and each of them has something to teach me. I just strive to be a positive light during their journeys and work to keep my patients safe, healthy, and happy.

Benjamin found his passion for healthcare while serving in the United States Navy as a Hospital Corpsman. Shortly after moving back to Texas, he attended The University of Texas Medical Branch to obtain his Bachelor’s of Science in Nursing. Benjamin went on to earn his Master’s of Science in Nursing - Family Nurse Practitioner from The University of Texas Medical Branch as well.

Benjamin is board certified through the American Association of Nurse Practitioners and a member of Sigma Theta Tau, the international nursing honor society. Benjamin also enjoys spending time as a Clinical Instructor for the School of Nursing at UTMB Galveston, where he is able to share his knowledge and experiences as a healthcare professional with future nurses.

Benjamin enjoys fishing, running, spending time with his wife and two rescue dogs, and staying active in church. He focuses on a holistic approach to patient care with an emphasis on disease prevention.

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Dr. Cynthia Binder joined UTMB Health Pediatric Community Based Clinics in 2002. She completed her residency in pediatrics at the University of Texas Medical Branch in Galveston where she also earned her medical degree. Dr. Binder holds a bachelor's degree from Baylor University.

Board certified by the American Board of Pediatrics, Dr. Binder enjoys providing healthcare and education to her patients and their families. Additionally, she enjoys teaching medical students and residents.

Dr. Binder enjoys all aspects of Pediatrics, but has a special interest in preventive medicine, infectious disease, and the treatment of asthma and allergic rhinitis.

Dr. Binder is bilingual in English and Spanish.

After being a Labor and Delivery / Nursery / Postpartum nurse for over 9 years, I decided to further my education and pursue a career in pediatrics. I have been practicing pediatrics in the Brazosport area for the last 3 years. I am passionate about providing quality, compassionate care to children as well as their families. I am married with two children and live in the Brazosport area, where I was born and raised. I enjoy spending time with my family, traveling, anything outdoors, and watching my son and daughter grow and excel in the extracurricular activities they are involved in.

Dr. Azhar joined UTMB's Department of Family Medicine in 1993. He attended medical school at Osmania Medical College in Hyderabad, India. Dr. Azhar completed his residency training in Ophthalmology at the Royal College of Surgeons in England then completed a fellowship in Neuro-Ophthalmogy at the University of Texas Health Science Center in Houston.

Dr. Azhar advanced his career by receiving additional residency training at UTMB in the Department of Family Medicine.  In addition to his doctorate degree, he earned an MBA from the University of Houston, Clear Lake.

Dr. Azhar is board certified in Family Medicine by the American Board of Family Medicine. Dr. Azhar's interests are in family medicine, ophthalmology and residency training.

Erika Schulze was born and raised in the Midwest in Illinois 30 minutes outside of St. Louis, MO. She completed her academic training at Goldfarb School of Nursing in St. Louis, MO. Her experience spans 16 years, which included working at Barnes Hospital as staff nurse on general medicine floor for 8 years; Pulmonary and Critical Care research at Washington University in St. Louis, MO. In 2003, Erika was accepted into graduate school at Goldfarb School of Nursing and completed Master of Science degree in Nursing with focus as an Adult Nurse Practitioner. This program was two and half years of additional medical assessment and decision training including diagnostic testing. Since completing Graduate School, she has worked in the primary care setting. She moved to Texas and started working at UTMB in January 2013.

During her time off, she enjoys her home, gardening, and time with her family and friends. She is passionate about animal welfare charities and animal fostering programs. Erika is also very passionate about the mental health of the community. She chairs a weekly support group, Nar Anon, for family and friends of those suffering from addiction.