Provider Demographics
NPI:1003516675
Name:GULF COAST PROCEDURE CENTER LLC
Entity Type:Organization
Organization Name:GULF COAST PROCEDURE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PURVI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-916-2075
Mailing Address - Street 1:13009 GULF COMMERCE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13009 GULF COMMERCE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034
Practice Address - Country:US
Practice Address - Phone:732-589-0816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GULF COAST PROCEDURE CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-03
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical