GULFSIDE MEDICAL CLINIC OF TEXAS, PA (NPI# 1386653277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386653277 |
| Entity Type | Organization |
| Organization Name | GULFSIDE MEDICAL CLINIC OF TEXAS, PA |
| Practice Address |
1209 Highway 35 N Suite A Rockport TX 78382-3117 |
| Practice Telephone | 3617299811 |
| Practice Fax Number | 3617299819 |
| Mailing Telephone | 3617299811 |
| Mailing Fax Number | 3617299819 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-11-19 |
| Authorized Official Name | JACK H BRACKIN (OWNER / PHYSICIAN) |
| Authorized Official Telephone | 3617299811 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | J0446 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS GROUP NUMBER | 0025PW | 01 |
| Street Address |
1209 HIGHWAY 35 N SUITE A |
| City | ROCKPORT |
| State | TX |
| Zip Code | 78382-3117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124037049 | Raffaele D Giovannone | Physician Assistant | 1209 Highway 35 N, Suite A, Rockport, TX 78382-3117 | 2006-08-07 |
| 1043784242 | Mcci of Texas Primary Care Group Pllc | Family Medicine | 1209 Highway 35 N, Rockport, TX 78382-4808 | 2019-01-22 |
| 1740756451 | Hillary Cherre Engleman | Nurse Practitioner | 1209 Highway 35 N, Rockport, TX 78382-4808 | 2018-10-19 |
| 1023515574 | Danielle Rae Cavignac | Nurse Practitioner | 1209 Highway 35 N, Rockport, TX 78382-4808 | 2018-04-11 |
| 1952719973 | Juaniece Miller | Nurse Practitioner | 1209 Highway 35 N, Suite A, Rockport, TX 78382-3117 | 2014-07-23 |
| 1528328309 | Yvette Valerio Alvarez | Family Medicine | 1209 Highway 35 N, Rockport, TX 78382-4808 | 2012-05-25 |
| 1992801179 | William Lewis Marr Iv | Physician Assistant | 1209 Highway 35 N, Rockport, TX 78382-4808 | 2006-09-15 |
| 1164431078 | Jack H Brackin | Family Medicine | 1209 Highway 35 N, Suite A, Rockport, TX 78382-3117 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618297 | Youngjoon Lee Kim | Dentist | 2347 Tx-35 Bus, Rockport, TX 78382 | 2020-08-03 |
| 1568013951 | Tracy Ann Oros | Nurse Practitioner | 400 North Enterprise, Rockport, TX 78382 | 2019-09-26 |
| 1831545219 | Gillian Cox | Registered Nurse | 161 Bernardy Rd, Rockport, TX 78382 | 2016-05-04 |
| 1043627029 | Jonathan Marcus Heyward | Counselor | 620 East Concho, Rockport, TX 78382 | 2014-07-22 |
| 1013322510 | Code 3 Emergency Physicians, Pa | Emergency Medicine | 400 Enterprise Blvd Ste A100, Rockport, TX 78382 | 2014-06-24 |
| 1114344728 | Barbara Bridges | Audiologist-Hearing Aid Fitter | 1723 Cherry St Ste 1, Rockport, TX 78382 | 2014-03-20 |
| 1962779959 | Lorraine Michele Cameron | Student in an Organized Health Care Education/Training Program | 1801 Omohundro Dr, Rockport, TX 78382 | 2011-11-19 |
| 1063723641 | Calvin Kimura | Pharmacist | 1309 Sh 35 N, Rockport, TX 78382 | 2010-06-29 |
| 1811212269 | Jadron LLC | Home Health | 2600 Lakeview Dr., St. 2, Rockport, TX 78382 | 2010-03-29 |
| 1316123342 | Linda Faye Lemmons | Speech-Language Pathologist | 1703 Bayshores Dr, Rockport, TX 78382 | 2008-01-22 |
| Find all providers in zip 78382 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619518891 | Ernest C. Alsop, Md, Pa | Family Medicine | 400 Enterprise Blvd Bldg D4, Rockport, TX 78382-4341 | 2019-09-30 |
| 1518283530 | Kendra Emery | Family Medicine | 7 Madelyn Ln Ste 200, Rockport, ME 04856 | 2010-04-15 |
| 1841320926 | Robert N. Merrill | Family Medicine | 821 Commercial St, Rockport, ME 04856-4243 | 2007-03-06 |
| 1184791618 | Susan M Martin | Family Medicine | 3434 W State Road 66, Rockport, IN 47635-9259 | 2006-11-29 |
| 1174632004 | Fred Dixon Warren | Family Medicine | 700 E Mimosa St, Rockport, TX 78382-4151 | 2006-08-30 |
| 1568571446 | Edwin Standifer Haun | Family Medicine | 400 Enterprise Blvd Ste 4, Rockport, TX 78382 | 2006-08-30 |
| 1437266434 | Julie H Hurley | Family Medicine | 7 Madelyn Lane, Suite 200, Rockport, ME 04856 | 2006-08-24 |
| 1265549869 | Mckim C Peterson | Family Medicine | 195 Union St, Midcoast Medicine, Pa, Rockport, ME 04856-6107 | 2006-08-23 |
| 1619084290 | Brian R Pierce | Family Medicine | 643 Rockland St, Suite C, Rockport, ME 04856-5320 | 2006-08-23 |
| 1235152760 | Judith Andersen | Family Medicine | 247 Commercial St, Suite C, Rockport, ME 04856-5964 | 2006-07-25 |
| Find all providers in ROCKPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.