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Organization
PRIVIA MEDICAL GROUP GULF COAST, PLLC
Active
Organization
PRIVIA MEDICAL GROUP GULF COAST, PLLC
Active
Other names
University Pain
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA JORDAN (DELEGATED OFFICIAL)
(713) 512-7613
Entity
Organization
Contact information
Practice address
1140 BUSINESS CENTER DR STE 110, HOUSTON, TX 77043-2749
(281) 896-0100
Mailing address
1200 BINZ ST STE 1490, HOUSTON, TX 77004-6946
(713) 512-7027
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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