Organization Active NPI

Gulf Coast Pathology Program PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Tomball, TX
National Provider Identifier
1730953886
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
GULF COAST PATHOLOGY PROGRAM PLLC
Practice address
605 Holderrieth Blvd
Tomball, TX 77375-6445
Phone
(281) 401-7617
NPI assigned
Nov 9, 2023
Last updated
Nov 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Michael Jamaine Davis
Title
Chief Financial Officer
Phone
(561) 402-4256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

605 Holderrieth Blvd
Tomball, TX 77375-6445

Mailing address

PO Box 746559
Atlanta, GA 30374-6559

National Provider Directory

National Provider Directory
Tax ID family
Gulf Coast Pathology Program PLLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1730953886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746559",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 HOLDERRIETH BLVD",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773756445",
            "telephone_number": "281-401-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST PATHOLOGY PROGRAM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMAINE",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "561-402-4256"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 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.