Privia Medical Group Gulf Coast, PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PRIVIA MEDICAL GROUP GULF COAST, PLLC

Doing business as

University Pain

Practice address

9305 Pinecroft Dr Ste 104
The Woodlands, TX 77380-3482

Phone

(281) 896-0013

Fax

(281) 896-0014

NPI assigned

Mar 26, 2020

Last updated

Apr 13, 2020By the provider in NPPES

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

Delegated Official

Phone

(713) 512-7613

Specialties & licenses 1

Addresses

Other names 1

• University Pain Doing business as

Locations

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586736000000",
    "number": "1972130003",
    "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",
            "telephone_number": "713-512-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 PINECROFT DR STE 104",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803482",
            "telephone_number": "281-896-0013",
            "fax_number": "281-896-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVIA MEDICAL GROUP GULF COAST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-26",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "713-512-7613"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Pain",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Pain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in The Woodlands, TX
• Providers in The Woodlands, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.