Greater Gulf Health Plan, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01486663 Issued in TX

Legal business name

GREATER GULF HEALTH PLAN, LLC

Practice address

260 N Sam Houston Pkwy E Ste 220
Houston, TX 77060-2022

Phone

(281) 447-6800

Fax

(281) 447-6802

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence J Wedekind

Title

President

Phone

(281) 447-6800

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Peter Alexander Bidwell, MD

  • Family Medicine Physician
  • Jasper, TX
  • NPI 1487650420
  NPD (past)
• Rick A Boyles, M.D.

  • Family Medicine Physician
  • Pasadena, TX
  • NPI 1356537799
  NPD (past)
• Wuju Dukja Chun, M.D.

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1134105752
  NPD (past)
• William J Crowley III, D.O.

  • Family Medicine Physician
  • Port Lavaca, TX
  • NPI 1609870161
  NPD (past)
• Peter Eugene Christian Forrest, M.D.

  • Family Medicine Physician
  • Burkeville, TX
  • NPI 1841321528
  NPD (past)
• Gholamreza Malek, M.D.

  • Diagnostic Radiology Physician
  • Houston, TX
  • NPI 1063498632
  NPD (past)
• Durba Mishra, MD

  • Internal Medicine Physician
  • Jasper, TX
  • NPI 1588673008
  NPD (past)
• David Anthony Mosig, D.O.

  • Emergency Medicine Physician
  • Jasper, TX
  • NPI 1548439979
  NPD (past)
• Floyd G Pohle, MD

  • Pediatrics Physician
  • Woodville, TX
  • NPI 1316945769
  NPD (past)
• John D Metoyer, CRNA

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
  • NPI 1619030384
  NPD (past)
• Naser Rahbar, M.D.

  • Diagnostic Radiology Physician
  • Anaheim, CA
  • NPI 1265547418
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1457574006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 N SAM HOUSTON PKWY E",
            "address_2": "SUITE 220",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770602018",
            "telephone_number": "281-447-6800",
            "fax_number": "281-447-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 N SAM HOUSTON PKWY E STE 220",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770602022",
            "telephone_number": "281-447-6800",
            "fax_number": "281-447-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER GULF HEALTH PLAN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "WEDEKIND",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-447-6800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "01486663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176768301",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176768302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "00690K",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Greater Dallas Healthcare Enterprises
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• Greater EMS Corp
• Greater EMS Corporation
• Greater Expert Medical Physicians
• Greater Heights & Memorial Pulmonary and Sleep Associates
• Greater Heights Anesthesia, PLLC
• Greater Heights Behavioral Health Associates PLLC
• Greater Heights Holistic Psychiatry
• Greater Heights Nephrology, PLLC

• General Practice Physician in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.