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Organization
PRIVIA MEDICAL GROUP GULF COAST PLLC
Active
Organization
PRIVIA MEDICAL GROUP GULF COAST PLLC
Active
Other names
Everest Foot and Ankle LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA JORDAN (AVP REVENUE CYCLEMANAGEMENT)
(713) 512-7613
Entity
Organization
Contact information
Practice address
6300 WEST LOOP S STE 390, BELLAIRE, TX 77401-2917
(346) 358-0150
Mailing address
1200 BINZ ST STE 1490, HOUSTON, TX 77004-6946
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
12/28/2022
Last updated
01/10/2023
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