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General NPI Number Information
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NPI Number | 1700683232
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Entity Type | Organization
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Legal Business Name | PRIVIA GULF COAST CARE ALLIANCE, LLC
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Dates
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Enumeration Date | 03/03/2025
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1200 BINZ ST STE 1490
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City | HOUSTON
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State | TX
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Zip | 77004-6946
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Country | US
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Telephone | 713-512-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 BINZ ST STE 1490
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City | HOUSTON
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State | TX
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Zip | 77004-6946
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Country | US
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Telephone | 713-512-7700
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGEMENT
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Name | BARBARA JORDAN
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Credential | AVP
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Telephone | 713-512-7613
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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