# PRIVIA MEDICAL GROUP GULF COAST PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Everest Foot and Ankle LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710690326
- **Authorized official:** BARBARA JORDAN (AVP REVENUE CYCLEMANAGEMENT)
- **Authorized official phone:** (713) 512-7613

## Contact information

- **Practice address:** 6300 WEST LOOP S STE 390, BELLAIRE, TX 77401-2917
- **Practice address phone:** (346) 358-0150
- **Mailing address:** 1200 BINZ ST STE 1490, HOUSTON, TX 77004-6946

## Taxonomy

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

## Other

- **Enumeration date:** 12/28/2022
- **Last updated:** 01/10/2023