Organization Active NPI

Gulf Coast MRI & Diagnostics, Inc.

  • Physiological Laboratory
  • Houston, TX
National Provider Identifier
1609823822
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
License
681367 Issued in TX
Legal business name
GULF COAST MRI & DIAGNOSTICS, INC.
Practice address
830 Gemini St
Houston, TX 77058
Phone
(281) 488-7226
Fax
(281) 488-2077
NPI assigned
May 31, 2006
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Mr. James Michael Latham
Title
Ceo
Phone
(281) 488-7226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X 681367 TX Primary

Addresses

Primary practice location

830 Gemini St
Houston, TX 77058

Mailing address

830 Gemini St
Houston, TX 77058-2702
Phone (281) 488-7226

Other practice location 1

3692 E Sam Houston Pkwy S
Pasadena, TX 77505-3137
Phone (281) 991-1674

Other practice location 2

11034 Scarsdale Blvd Ste A
Houston, TX 77089-5971
Phone (281) 481-1935

Other identifiers 1

IdentifierTypeStateIssuer
093951401MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20180625000198 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1456349828 Practice locations: Houston, TX
O20190618002604 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1456349828 Practice locations: Pasadena, TX
O20240321001743 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1456349828 Practice locations: Houston, 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
45D2000143Gulf Coast MRI & Diagnostic3692 East Sam Houston Pkwy South Suite 200, Pasadena, TX 77505Certificate of waiverSep 29, 2026
45D2000145Gulf Coast MRI & Diagnostic830 Gemini, Houston, TX 77058Certificate of waiverMar 30, 2027
45D2028782Gulf Coast MRI & Diagnostic Scarsdale11034 Scarsdale Blvd, Suite a, Houston, TX 77089Certificate of waiverAug 23, 2027

National Provider Directory

National Provider Directory

Locations

4001 W Sam Houston Pkwy N
Ste 100
Houston, TX 77043
Phone (713) 996-0900

8111 Southwest Fwy
Ste 100
Houston, TX 77074
Phone (713) 541-6111

3692 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (281) 487-6736

3692 Fairmont Pkwy
Gulf Coast MRI Ctr Pasadena
Pasadena, TX 77504
Phone (281) 991-1674

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1609823822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 GEMINI ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770582702",
            "telephone_number": "281-488-7226",
            "fax_number": "281-488-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 GEMINI ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77058",
            "telephone_number": "281-488-7226",
            "fax_number": "281-488-2077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3692 E Sam Houston Pkwy S",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775053137",
            "country_code": "US",
            "telephone_number": "281-991-1674",
            "fax_number": "281-991-3800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11034 Scarsdale Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770895971",
            "country_code": "US",
            "telephone_number": "281-481-1935",
            "fax_number": "281-481-1992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GULF COAST MRI & DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "LATHAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "281-488-7226",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "TX",
            "license": "681367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "093951401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.