Privia Medical Group Gulf Coast, Pllc

NPI #1053926550 in Magnolia, Texas

Provider Information

NPI Number: 1053926550
Entity Type: Organization
Organization Name: Privia Medical Group Gulf Coast, Pllc
Primary Specialty: Internal Medicine
Enumeration Date: Sep 11, 2020
Last Updated: Sep 11, 2020

Practice Location

Address: 10020 RESEARCH FOREST DR STE D
City: Magnolia
State: Texas
ZIP Code: 77354-6780
Phone: (281) 896-0013

Authorized Official

Name: BARBARA JORDAN
Title: DELEGATED OFFICIAL
Phone: (713) 512-7613

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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