Organization
PRIVIA MEDICAL GROUP GULF COAST PLLC
Active
Parent organization
PRIVIA MEDICAL GROUP GULF COAST PLLC
Other names
Express Pain and Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIVIA MEDICAL GROUP GULF COAST PLLC
Authorized official
BARBARA JORDAN (AVP)
(713) 512-7613
Entity
Organization
Contact information
Practice address
5939 BABCOCK RD STE 112, SAN ANTONIO, TX 78240-3462
(210) 874-5260
Mailing address
1200 BINZ ST STE 1490, HOUSTON, TX 77004-6946
(210) 874-5260
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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