# PRIVIA MEDICAL GROUP GULF COAST, PLLC

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

## Provider details

- **NPI number:** 1669134813
- **Authorized official:** BARBARA JORDAN (AVP, REVENUE CYCLE MANAGEMENT)
- **Authorized official phone:** (713) 512-7613

## Contact information

- **Practice address:** NUCARE FOOT & ANKLE SPECIALISTS, 12238 QUEENSTON BLVD, STE K, HOUSTON, TX 77095-5351
- **Practice address phone:** (281) 982-0868
- **Practice address fax:** (281) 982-0866
- **Mailing address:** 1200 BINZ ST STE 1490, HOUSTON, TX 77004-6946
- **Mailing address phone:** (713) 512-7700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | Yes |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | Yes |

## Other

- **Enumeration date:** 10/05/2021
- **Last updated:** 10/05/2021