Organization Active NPI

South Coast Health Care of Texas, PA

  • General Practice Physician
  • Victoria, TX
National Provider Identifier
1508882036
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SOUTH COAST HEALTH CARE OF TEXAS, PA
Practice address
2700 Citizens PLZ Ste 100
Victoria, TX 77901-5756
Phone
(361) 579-1371
Fax
(361) 579-1373
NPI assigned
Jul 15, 2006
Last updated
May 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Don McKay
Title
Ceo
Phone
(361) 572-0333

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

2700 Citizens PLZ Ste 100
Victoria, TX 77901-5756

Mailing address

1908 N Laurent St Ste 410
Victoria, TX 77901-5469
Phone (361) 572-0333

Other identifiers 2

IdentifierTypeStateIssuer
081198601MedicaidTX
0081AXOtherTXBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050328000820 TX Part B Supplier - Clinic/Group Practice 3274589742 Receives reassigned benefits from 7 practitioners
Practice locations: Victoria, 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
45D0973970South Coast Health Care of Texas, PA2700 Citizens Plaza Suite 100, Victoria, TX 77901Certificate of waiverDec 19, 2027

National Provider Directory

National Provider Directory

Locations

2700 Citizens Plz
#100S
Victoria, TX 77901
Phone (361) 579-1371

601 E San Antonio St
#203
Victoria, TX 77901
Phone (361) 576-0004

605 E San Antonio St
#410S
Victoria, TX 77901
Phone (512) 788-6700

Practitioners & affiliated clinicians

Practitioners 9

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": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1508882036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 N LAURENT ST STE 410",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015469",
            "telephone_number": "361-572-0333",
            "fax_number": "361-572-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 CITIZENS PLZ STE 100",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015756",
            "telephone_number": "361-579-1371",
            "fax_number": "361-579-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COAST HEALTH CARE OF TEXAS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "MCKAY",
        "authorized_official_first_name": "DON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "361-572-0333"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081198601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0081AX",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.