NPIMap

Organization Active NPI

Gulf Coast Psychology PLLC

Doing business as Mary Ann Gansle Sole MBR

  • Psychologist
  • Portland, TX
National Provider Identifier
1629346606
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
35139 Issued in TX
Legal business name
GULF COAST PSYCHOLOGY PLLC
Doing business as
Mary Ann Gansle Sole MBR
Practice address
1700 Wildcat Dr Ste D
Portland, TX 78374-2817
Phone
(361) 445-4080
Fax
(888) 413-3010
NPI assigned
Dec 6, 2011
Last updated
Dec 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Authorized official

Name
Dr. Mary Ann Gansle, PH.D.
Title
Psychologist
Phone
(361) 445-4080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 35139 TX Primary

Addresses

Primary practice location

1700 Wildcat Dr Ste D
Portland, TX 78374-2817

Mailing address

PO Box 2
Portland, TX 78374-0002
Phone (361) 445-4080

Other names 1

  • Mary Ann Gansle Sole MBR Doing business as

National Provider Directory

National Provider Directory

Locations

2806 Highway 35 N
Rockport, TX 78382
Phone (361) 727-0143

Practitioners & affiliated clinicians

Practitioners 3

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": "1323129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1629346606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783740002",
            "telephone_number": "361-445-4080",
            "fax_number": "888-413-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WILDCAT DR STE D",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783742817",
            "telephone_number": "361-445-4080",
            "fax_number": "888-413-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST PSYCHOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "GANSLE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "361-445-4080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "TX",
            "license": "35139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Ann Gansle Sole MBR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.