Gulf Coast Imaging & Associates, LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

Legal business name

GULF COAST IMAGING & ASSOCIATES, LLC

Practice address

500 E Caesar Ave Ste B
Kingsville, TX 78363-6322

Phone

(361) 221-8101

NPI assigned

May 17, 2018

Organization subpart

No

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

Authorized official

Name

Leonel Rivera, RN-BSN

Title

Owner

Phone

(361) 563-3352

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Portable X-ray supplier certification: CCN 45X0009933

Legal name

GULF COAST IMAGING & ASSOCIATES LLC

Certification status

Active

Provider type (POS)

Portable X-ray supplier

Participating since

May 4, 2023

Last certification

Apr 5, 2023

Ownership / control type

Partnership

Facility address

500 E Caesar Ave Ste B
Kingsville, TX 78363

Locations

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1750871414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E CAESAR AVE STE B",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783636322",
            "telephone_number": "361-221-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E CAESAR AVE STE B",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783636322",
            "telephone_number": "361-221-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST IMAGING & ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-17",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "LEONEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "361-563-3352",
        "authorized_official_credential": "RN-BSN"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica M. Gonzalez, O. D.
• Jaclyn Eileen Gonzalez, MS, LAT, ATC
• Melva Ann Gonzalez, COTA
• Heather A Goodall, APRN
• Priscilla Ann Guevara
• H-E-B, LP (Heb Pharmacy #401)
• Kelly Haley, LPC ASSOCIATE
• Daniel Charles Hansen, IDC
• Happy Speech Services, PLLC
• Robert Harbolovic

• Mobile Radiology Clinic/Center in Kingsville, TX
• Providers in Kingsville, TX by specialty
• Mobile Radiology Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.