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General NPI Number Information
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NPI Number | 1639176324
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Entity Type | Organization
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Legal Business Name | GULF COAST HEALTH CENTER INC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 103 EAST GIBSON SUITE 110 &112
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City | JASPER
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State | TX
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Zip | 75951
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Country | US
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Telephone | 409-379-8338
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Fax | 409-983-4933
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Provider Business Mailing Address
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Address Line | 2548 MEMORIAL BLVD
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City | PORT ARTHUR
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State | TX
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Zip | 77640-2825
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Country | US
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Telephone | 409-983-1161
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Fax | 409-983-4933
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. MARSHA E THIGPEN
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Credential | MD
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Telephone | 409-983-1161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | TX
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