Privia Medical Group Gulf Coast PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PRIVIA MEDICAL GROUP GULF COAST PLLC

Practice address

6300 West Loop S Ste 390
Bellaire, TX 77401-2917

Phone

(346) 358-0150

NPI assigned

Dec 28, 2022

Organization subpart

No

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

Authorized official

Name

Barbara Jordan

Title

Avp Revenue Cyclemanagement

Phone

(713) 512-7613

Specialties & licenses 1

Addresses

Other names 1

• Everest Foot and Ankle LLC Doing business as

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

{
    "created_epoch": "1672185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1710690326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BINZ ST STE 1490",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 WEST LOOP S STE 390",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774012917",
            "telephone_number": "346-358-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP GULF COAST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-28",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "AVP REVENUE CYCLEMANAGEMENT",
        "authorized_official_telephone_number": "713-512-7613"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Everest Foot and Ankle LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Everest Foot and Ankle LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premier Kidney Care, PLLC
• Premier Physiatry PLLC
• Connie Price, LCSW
• Julia L Prillaman
• Alison Prince, LPC-INTERN
• Proactive Minds, PA
• Peter H Proctor, MD
• Professional Anesthesiologists of Texas, P.a.
• Pamela A Promecene-Cook, M.D.
• Providentia DME

• Foot & Ankle Surgery Podiatrist in Bellaire, TX
• Providers in Bellaire, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.