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NPI Code Detail

MEDICARE: THE GULF COAST CENTER

MEDICARE: THE GULF COAST CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management AgencyTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801939541
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE GULF COAST CENTER
Provider Business Mailing Address
First Line : 4444 W MAIN ST
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-1737
Country : US
Telephone Number : 409-763-2373
Fax Number :
Provider Business Practice Location Address
First Line : 4444 W MAIN ST
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-1737
Country : US
Telephone Number : 409-763-2373
Fax Number :
Authorized Official
Title or Position : CFO
Name : RICK ELIZONDO
Credential :
Telephone Number : 409-763-2373
Provider Enumeration Date : 02/14/2007
Last Update Date : 09/23/2022

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Directions to “THE GULF COAST CENTER ” Practice Location

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