PRIVIA MEDICAL GROUP GULF COAST, PLLC (NPI# 1578969465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578969465 |
| Entity Type | Organization |
| Organization Name | PRIVIA MEDICAL GROUP GULF COAST, PLLC |
| Other Organization Name | SOUTHWEST WOMEN'S HEALTH ALLIANCE, PLLC |
| Practice Address |
7900 Fannin St Ste 4000 Houston TX 77054-2935 |
| Mailing Address |
1213 Hermann Dr Ste 820 Houston TX 77004-7014 |
| Practice Telephone | 7135127500 |
| Mailing Telephone | 7135127027 |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2017-08-08 |
| Authorized Official Name | JIM EDWARDS (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Telephone | 7135127083 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VE0102X |
Obstetrics & Gynecology Specialization: Reproductive Endocrinology |
Allopathic & Osteopathic Physicians | ||
| N | 207VF0040X |
Obstetrics & Gynecology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| N | 291U00000X | Clinical Medical Laboratory | Laboratories | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Southwest Women's Health Alliance, PLLC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053926550 | Privia Medical Group Gulf Coast, Pllc | Internal Medicine | 10020 Research Forest Dr Ste D, Magnolia, TX 77354-6780 | 2020-09-11 |
| 1417562919 | Privia Medical Group Gulf Coast, Pllc | Internal Medicine | 1140 Business Center Dr Ste 110, Houston, TX 77043-2749 | 2020-09-11 |
| 1972130003 | Privia Medical Group Gulf Coast, Pllc | Internal Medicine | 9305 Pinecroft Dr Ste 104, The Woodlands, TX 77380-3482 | 2020-03-26 |
| Street Address |
7900 FANNIN ST STE 4000 |
| City | HOUSTON |
| State | TX |
| Zip Code | 77054-2935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396748349 | George M Grunert | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston Fertility Specialists Pllc, Houston, TX 77054-2935 | 2005-05-23 |
| 1063939700 | Privia Medical Group Gulf Coast Rx Health Services, LLC | Specialist | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2017-08-24 |
| 1568825693 | Sameen Nooruddin | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2016-04-05 |
| 1548640253 | Lucia Pacheco | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2015-06-08 |
| 1497151351 | Houston Fertility Specialists, Pllc | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2014-11-05 |
| 1396140588 | The Breast and Imaging Center, LLC | Specialist | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2014-10-30 |
| 1528300787 | Ann Lu Jenkins | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054 | 2013-03-26 |
| 1689801318 | Jessica Rose Rosenstock | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Obgyn Medical Center Associates Pllc, Houston, TX 77054-2935 | 2009-06-21 |
| 1972770105 | Hilaire Wood Fisher | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Houston, TX 77054-2935 | 2008-05-16 |
| 1902099617 | Carrie Jeanette Ball | Obstetrics & Gynecology | 7900 Fannin St Ste 4000, Obgyn Medical Center Associates Pllc, Houston, TX 77054-2935 | 2007-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467006924 | Sphinx Pharmacy Group Webster Inc | Pharmacy | 2656 S Loop W Suite 275, Houston, TX 77054 | 2019-08-01 |
| 1164076618 | Pearland Unicare Pharmacy LLC | Pharmacy | 7400 Fannin Street Suite 120, Houson, TX 77054 | 2019-08-01 |
| 1144873092 | Megan Hoenig | Genetic Counselor, MS | 2525-a Holly Hall St., Suite 3c, Houston, TX 77054 | 2019-07-19 |
| 1043781701 | Lisa Vercellino Salazar | Nurse Practitioner | The Woman's Hospital of Texas, 7600 Fannin, Houston, TX 77054 | 2018-12-06 |
| 1619447257 | Karee Harris | Specialist/Technologist, Other | 7400 Fannin St Suite 850 Tx, Houston, TX 77054 | 2018-11-27 |
| 1245715374 | Van Hoai Thi Hoang | Pharmacist | 2525a Holly Hall, Houston, TX 77054 | 2018-09-25 |
| 1093294639 | Yolanda Williams-vasquez | Licensed Vocational Nurse | 3131 W Bellfort Ave, Houston, TX 77054 | 2018-08-13 |
| 1104304542 | Reji Mammen | Dentist | 2120 El Paseo St., Apt 2607, Houston, TX 77054 | 2018-07-28 |
| 1912484825 | Saeed Yazdianpour | Dentist | 7600 Cambridge St, Houston, TX 77054 | 2018-07-24 |
| 1811480742 | Dominik Andrzej Rudecki | Student in an Organized Health Care Education/Training Program | 7500 Cambridge St, Suite 6510, Houston, TX 77054 | 2018-06-14 |
| Find all providers in zip 77054 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487273 | Victoria Ann Petruzzi | Obstetrics & Gynecology | 1401 St. Joseph Pkwy., Sks1106a, Houston, TX 77002 | 2020-05-04 |
| 1962052605 | Sharee Anne Valencia | Obstetrics & Gynecology | 11947 North Fwy, Houston, TX 77060-1700 | 2019-09-15 |
| 1881251239 | Andrea Marie Costello | Obstetrics & Gynecology | Gme, Attn: Dottie Mersinger, 6670 Bertner Ave., R2-216, Houston, TX 77030 | 2019-05-21 |
| 1144784406 | Martha Laird | Obstetrics & Gynecology | 5618 Bankside Dr, Houston, TX 77096-6119 | 2019-01-30 |
| 1588134407 | The Women's Health Solution | Obstetrics & Gynecology | 5751 Blythewood St Ste 200, Houston, TX 77021-5404 | 2018-12-04 |
| 1720569411 | Champions Women's Center, P.a. | Obstetrics & Gynecology | 17070 Red Oak Dr Ste 400, Houston, TX 77090-2616 | 2018-08-22 |
| 1942711668 | Total Women's Care Pllc | Obstetrics & Gynecology | 2050 North Loop W Ste 130, Houston, TX 77018-8111 | 2017-10-20 |
| 1821451667 | L. Natalie Carroll, M.d. P A | Obstetrics & Gynecology | 2656 S Loop W Ste 575, Houston, TX 77054-5622 | 2016-03-30 |
| 1841652120 | Iris Alejandra Trochez Valladares | Obstetrics & Gynecology | 13215 Dotson Rd Ste 200, Houston, TX 77070-4535 | 2016-03-24 |
| 1255702544 | Leen Al-hafez | Obstetrics & Gynecology | 3105 Norfolk St, Apartment 18305, Houston, TX 77098-2916 | 2015-10-12 |
| Find all providers in HOUSTON | ||||
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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.