# GULF COAST VISION CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275993248
- **Authorized official:** JELITA GREEN (DIRECTOR)
- **Authorized official phone:** (832) 628-5126

## Contact information

- **Practice address:** 2636 SOUTH LOOP WEST, SUITE 500, HOUSTON, TX 77054-0001
- **Practice address phone:** (713) 790-0513
- **Practice address fax:** (713) 790-0514
- **Mailing address:** 11601 SHADOW CREEK PKWY \# 111-543, PEARLAND, TX 77584-7283
- **Mailing address phone:** (713) 790-0513
- **Mailing address fax:** (713) 790-0514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 7460TG | TX | Yes |

## Other

- **Enumeration date:** 03/03/2016
- **Last updated:** 03/03/2016