Provider Demographics
NPI:1225228547
Name:GULF COAST SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:GULF COAST SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND BOARD CHAIR
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEOPLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-873-3520
Mailing Address - Street 1:402 DUNN ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4704
Mailing Address - Country:US
Mailing Address - Phone:985-872-1661
Mailing Address - Fax:985-868-5883
Practice Address - Street 1:402 DUNN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4704
Practice Address - Country:US
Practice Address - Phone:985-872-1661
Practice Address - Fax:985-868-5883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical