Gulf Coast Eye Center, P.a.

Primary specialty

Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X

License

J4298 Issued in TX

Legal business name

GULF COAST EYE CENTER, P.A.

Practice address

117 Circle Way St
Lake Jackson, TX 77566-5233

Phone

(979) 297-4042

Fax

(979) 297-4686

NPI assigned

May 8, 2007

Organization subpart

No

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

Authorized official

Name

Jane Hoyt Leidlein, M.D.

Title

President

Phone

(979) 297-4042

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1366655854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CIRCLE WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665233",
            "telephone_number": "979-297-4042",
            "fax_number": "979-297-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CIRCLE WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665233",
            "telephone_number": "979-297-4042",
            "fax_number": "979-297-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST EYE CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "LEIDLEIN",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "HOYT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-297-4042",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "TX",
            "license": "J4298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "180036211",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096931303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "28MV",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drjane@myeyedoctorjane.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "117 Circle Way St",
            "city": "Lake Jackson",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775665233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Ophthalmologic Surgery Clinic/Center in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Ophthalmologic Surgery Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.