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General NPI Number Information
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NPI Number | 1336407170
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Entity Type | Organization
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Legal Business Name | GULF COAST VISITING PHYSICIANS PLLC
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Dates
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Enumeration Date | 04/30/2012
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Last Update Date | 04/30/2012
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Provider Practice Location Address
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Address Line | 10301 NORTHWEST FWY SUITE 307
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City | HOUSTON
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State | TX
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Zip | 77092-8225
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Country | US
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Telephone | 713-263-9994
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Fax | 713-263-9946
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Provider Business Mailing Address
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Address Line | 10301 NORTHWEST FWY SUITE 307
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City | HOUSTON
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State | TX
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Zip | 77092-8225
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Country | US
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Telephone | 713-263-9994
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Fax | 713-263-9946
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT BRODSKY
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Credential |
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Telephone | 713-263-9994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | N5003
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License Number State | TX
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