Active NPI
GCMC of Wharton County Texas, LLC
Doing business as Gulf Coast Medical Center
- General Acute Care Hospital
- Wharton, TX
National Provider Identifier
1013910868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 100142
- Legal business name
- GCMC OF WHARTON COUNTY TEXAS, LLC
- Doing business as
- Gulf Coast Medical Center
- Practice address
- 10141 US 59 Rd
Wharton, TX 77488-7224 - Phone
- (979) 282-6141
- Fax
- (979) 282-6036
- NPI assigned
- May 24, 2005
- Last updated
- Oct 18, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kevin D Crandall
- Title
- Cio
- Phone
- (480) 650-7534
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 008330 | TX | |
| General Acute Care Hospital | 282N00000X | 100142 | TX | Primary |
Addresses
Primary practice location
10141 US 59 Rd
Wharton, TX 77488-7224
Mailing address
PO Box 4869, Dept 407a
Houston, TX 77210-4869
Phone (480) 650-7534
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178848101 | Medicaid | TX | |
| 45D0495923 | Other | TX | CLIA # FOR LABORATORY |
| 45D0679101 | Other | TX | CLIA # CARDIO BLOOD GAS |
| HH0522 | Other | TX | BLUE CROSS ACUTE |
| 014503 | Other | TX | TDH BUREAU OF KIDNEY HLTH |
| 16213213594002 | Other | TX | TEXAS REHAB VENDOR # |
| 1363335 06 | Medicaid | TX | |
| 1363335 04 | Medicaid | TX | |
| 178815003 | Medicaid | TX | |
| HH2802 | Other | TX | BLUE CROSS SNF |
| 178815001 | Medicaid | TX | |
| 178815002 | Medicaid | TX | |
| 621321359774880000 | Other | TX | CHAMPUS PROVIDER # |
| TAX ID | Other | TX | 203745677 |
Other names 1
- Gulf Coast Medical Center
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1476748800000",
"number": "1013910868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4869, DEPT 407A",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772104869",
"telephone_number": "480-650-7534",
"fax_number": "480-219-5572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10141 US 59 RD",
"city": "WHARTON",
"state": "TX",
"postal_code": "774887224",
"telephone_number": "979-282-6141",
"fax_number": "979-282-6036"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GCMC OF WHARTON COUNTY TEXAS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-24",
"last_updated": "2016-10-18",
"status": "A",
"authorized_official_last_name": "CRANDALL",
"authorized_official_first_name": "KEVIN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "CIO",
"authorized_official_telephone_number": "480-650-7534",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "TX",
"license": "008330",
"primary": false
},
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "TX",
"license": "100142",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "178848101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA # FOR LABORATORY",
"identifier": "45D0495923",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA # CARDIO BLOOD GAS",
"identifier": "45D0679101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS ACUTE",
"identifier": "HH0522",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TDH BUREAU OF KIDNEY HLTH",
"identifier": "014503",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS REHAB VENDOR #",
"identifier": "16213213594002",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1363335 06",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1363335 04",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "178815003",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS SNF",
"identifier": "HH2802",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "178815001",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "178815002",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS PROVIDER #",
"identifier": "621321359774880000",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "203745677",
"identifier": "TAX ID",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Gulf Coast Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Wharton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.