| The Gulf Coast Center | |
|
7510 Fm 1765 Texas City TX 77591-3672 | |
| (409) 763-2373 | |
| (409) 978-2401 |
| Full Name | The Gulf Coast Center |
|---|---|
| Speciality | Counselor |
| Location | 7510 Fm 1765, Texas City, Texas |
| Authorized Official Name and Position | Rick Elizondo (CFO) |
| Authorized Official Contact | 4097632373 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Gulf Coast Center 4444 W Main St League City TX 77573-1737 Ph: (409) 763-2373 | The Gulf Coast Center 7510 Fm 1765 Texas City TX 77591-3672 Ph: (409) 763-2373 |
| NPI Number | 1538202270 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 09/23/2022 |
| Certification Date | 10/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538202270 | NPI | - | NPPES |
| 135222105 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Texas) | Primary |
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