Organization Active NPI

Port Arthur Cardiac Cath Lab, LP

Doing business as Gulf Coast Cath Lab

  • Multi-Specialty Clinic/Center
  • Port Arthur, TX
National Provider Identifier
1245462258
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PORT ARTHUR CARDIAC CATH LAB, LP
Doing business as
Gulf Coast Cath Lab
Practice address
3919 N Twin City Hwy
Port Arthur, TX 77642-2118
Phone
(409) 984-7090
Fax
(409) 984-7099
NPI assigned
Aug 10, 2009
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Kelly Marie Bemis
Title
Authorized Official
Phone
(858) 504-5667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

3919 N Twin City Hwy
Port Arthur, TX 77642-2118

Mailing address

Dept# 3009, PO Box 4417
Houston, TX 77210-4417
Phone (610) 644-8900

Other names 1

  • Gulf Coast Cath Lab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091104000177 TX Part B Supplier - Clinic/Group Practice 8426196999 Receives reassigned benefits from 4 practitioners
Practice locations: Port Arthur, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2000515Port Arthur Cardiac Cath Lab3919 Twin City Hwy, Port Arthur, TX 77642AccreditationSep 14, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

3919 N Twin City Hwy
Ste A
Port Arthur, TX 77642

3921 N Twin City Hwy
Ste A
Port Arthur, TX 77642
Phone (409) 984-7090

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1245462258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT# 3009, PO BOX 4417",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104417",
            "telephone_number": "610-644-8900",
            "fax_number": "484-924-0053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 N TWIN CITY HWY",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776422118",
            "telephone_number": "409-984-7090",
            "fax_number": "409-984-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT ARTHUR CARDIAC CATH LAB, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-10",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "BEMIS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "858-504-5667"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Cath Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gulf Coast Cath Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Arthur, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.