# PRIVIA MEDICAL GROUP GULF COAST, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southwest Women's Health Alliance, PLLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578969465
- **Authorized official:** BARBARA JORDAN (AVP REVENUE CYCLE MANAGEMENT)
- **Authorized official phone:** (713) 512-7613

## Contact information

- **Practice address:** 7900 FANNIN ST STE 4000, HOUSTON, TX 77054-2935
- **Practice address phone:** (713) 512-7500
- **Mailing address:** 1200 BINZ ST STE 1490, HOUSTON, TX 77004-6946
- **Mailing address phone:** (713) 512-7613

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VE0102X | Reproductive Endocrinology Physician | — | NULL | — |
| 207VE0102X | Reproductive Endocrinology Physician | — | — | — |
| 207VF0040X | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician | — | NULL | — |
| 207VF0040X | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician | — | — | — |
| 207VG0400X | Gynecology Physician | — | NULL | — |
| 207VG0400X | Gynecology Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 291U00000X | Clinical Medical Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 11/05/2014
- **Last updated:** 03/17/2024