PRIVIA MEDICAL GROUP GULF COAST RX HEALTH SERVICES, LLC (NPI# 1063939700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063939700 |
| Entity Type | Organization |
| Organization Name | PRIVIA MEDICAL GROUP GULF COAST RX HEALTH SERVICES, LLC |
| Practice Address |
7900 Fannin St Ste 4000 Houston TX 77054-2935 |
| Mailing Address |
1213 Hermann Dr Ste 820 Houston TX 77004-7014 |
| Practice Telephone | 7135127700 |
| Practice Fax Number | 7135127039 |
| Mailing Telephone | 7135127700 |
| Mailing Fax Number | 7135127039 |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2017-08-24 |
| Authorized Official Name | JIM EDWARDS (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 7135127083 |
| Is Organization Subpart | Y |
| Parent Organization Name | PRIVIA MEDICAL GROUP GULF COAST, PLLC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093271231 | Privia Medical Group Gulf Coast Rx Health Services, LLC | Pharmacy | 9539 Huffmeister Rd Ste C, Houston, TX 77095-2856 | 2019-02-12 |
| Street Address |
7900 FANNIN ST STE 4000 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77054-2935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748349 | George M Grunert | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston Fertility Specialists Pllc, Houston, TX 77054-2935 | 2005-05-23 |
| 1568825693 | Sameen Nooruddin | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2016-04-05 |
| 1548640253 | Lucia Pacheco | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2015-06-08 |
| 1497151351 | Houston Fertility Specialists, Pllc | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2014-11-05 |
| 1578969465 | Privia Medical Group Gulf Coast, Pllc | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2014-11-05 |
| 1396140588 | The Breast and Imaging Center, LLC | Specialist | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2014-10-30 |
| 1528300787 | Ann Lu Jenkins | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054 | 2013-03-26 |
| 1689801318 | Jessica Rose Rosenstock | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Obgyn Medical Center Associates Pllc, Houston, TX 77054-2935 | 2009-06-21 |
| 1972770105 | Hilaire Wood Fisher | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2008-05-16 |
| 1902099617 | Carrie Jeanette Ball | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Obgyn Medical Center Associates Pllc, Houston, TX 77054-2935 | 2007-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467006924 | Sphinx Pharmacy Group Webster Inc | Pharmacy | 2656 S Loop W Suite 275, Houston, TX 77054 | 2019-08-01 |
| 1164076618 | Pearland Unicare Pharmacy LLC | Pharmacy | 7400 Fannin Street Suite 120, Houson, TX 77054 | 2019-08-01 |
| 1144873092 | Megan Hoenig | Genetic Counselor, MS | 2525-a Holly Hall St., Suite 3c, Houston, TX 77054 | 2019-07-19 |
| 1043781701 | Lisa Vercellino Salazar | Nurse Practitioner | The Woman's Hospital of Texas, 7600 Fannin, Houston, TX 77054 | 2018-12-06 |
| 1619447257 | Karee Harris | Specialist/Technologist, Other | 7400 Fannin St Suite 850 Tx, Houston, TX 77054 | 2018-11-27 |
| 1245715374 | Van Hoai Thi Hoang | Pharmacist | 2525a Holly Hall, Houston, TX 77054 | 2018-09-25 |
| 1093294639 | Yolanda Williams-vasquez | Licensed Vocational Nurse | 3131 W Bellfort Ave, Houston, TX 77054 | 2018-08-13 |
| 1104304542 | Reji Mammen | Dentist | 2120 El Paseo St., Apt 2607, Houston, TX 77054 | 2018-07-28 |
| 1912484825 | Saeed Yazdianpour | Dentist | 7600 Cambridge St, Houston, TX 77054 | 2018-07-24 |
| 1811480742 | Dominik Andrzej Rudecki | Student in an Organized Health Care Education/Training Program | 7500 Cambridge St, Suite 6510, Houston, TX 77054 | 2018-06-14 |
| Find all providers in zip 77054 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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|---|---|---|---|---|
| 1255949152 | Angelica Rosas-torres | Specialist | 9810 Brick Village Dr, Houston, TX 77095-5072 | 2020-07-16 |
| 1689202004 | Bayou Surgical Assistants Inc | Specialist | 121 N Post Oak Ln Apt 2204, Houston, TX 77024-7717 | 2020-03-31 |
| 1588290761 | Jim Gigante | Specialist | 5607 Fountainbridge Ln, Houston, TX 77069-1917 | 2020-03-19 |
| 1043840044 | Valerie Pedraza | Specialist | 9802d Ella Blvd, Houston, TX 77038-3030 | 2020-01-19 |
| 1386200178 | Thaddieus A Reed | Specialist | 3605 Wilmington St, Houston, TX 77051-3248 | 2019-05-16 |
| 1437617545 | Wellness Institute of Neurodevelopment | Specialist | 5757 Woodway Dr Ste 190, Houston, TX 77057-1526 | 2019-03-07 |
| 1275098568 | Idoc Virtual Telehealth Texas | Specialist | 2311 W Main St, Houston, TX 77098-3218 | 2019-01-31 |
| 1326531708 | Houston Neurology Clinical & Diagnostic Consultants Company | Specialist | 1313 La Concha Ln Ste 130, Houston, TX 77054-1809 | 2018-06-11 |
| 1154840908 | Webster Diagnostics, Pllc | Specialist | 18333 Egret Bay Blvd Ste 200, Houston, TX 77058-3200 | 2017-09-13 |
| 1093242166 | Cns Medical Group | Specialist | 6238 Rietta St, Houston, TX 77016-4338 | 2017-05-18 |
| Find all providers in HOUSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.