Healthcare Provider Details

I. General information

NPI: 1861416117
Provider Name (Legal Business Name): GULF COAST NEPHROLOGY LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/07/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 SOUTHWEST FWY SUITE 1052
HOUSTON TX
77074
US

IV. Provider business mailing address

450 THIS WAY ST STE B
LAKE JACKSON TX
77566-5152
US

V. Phone/Fax

Practice location:
  • Phone: 713-988-8776
  • Fax: 713-988-8662
Mailing address:
  • Phone: 979-299-0091
  • Fax: 713-988-8662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGARITA FELAN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 979-297-2220