Organization
PRIVIA MEDICAL GROUP GULF COAST PLLC
Active
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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