Organization
PRIVIA MEDICAL GROUP GULF COAST PLLC
Active
Other names
PRIVIA MEDICAL GROUP GULF COAST
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA JORDAN (AUTHORIZED OFFICIAL)
(713) 512-7613
Entity
Organization
Contact information
Practice address
4900 BEE CREEK RD UNIT 203, SPICEWOOD, TX 78669-7018
(512) 907-3100
Mailing address
1200 BINZ ST STE 1490, HOUSTON, TX 77004-6946
(713) 512-7700
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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