THE GULF COAST CENTER – Psychiatry Physician, NPI 1245285899
Psychiatry Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for THE GULF COAST CENTER
101 Tigner St
Angleton, TX 775154568
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
3201 Fm 2004 Rd
Texas City, TX 775912199
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
101 Brennen Ln
Alvin, TX 775113533
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
7510 Fm 1765
Texas City, TX 775913672
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
2352 E Mulberry St
Angleton, TX 775153805
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
4444 W Main St
League City, TX 775731737
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
1207 Oak St
LA Marque, TX 775685925
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
4700 Broadway St Ste 100
Galveston, TX 775514241
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
7510 FM 1765
TEXAS CITY, TX 775913672
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Location
West Main Street, League City, Galveston County, Texas, 77573, United States
LEAGUE CITY, TX 775731737
Phone: (409) 763-2373
Fax: (409) 978-2401
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-04-14
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-09-30 (252 days ago).
Enrollment records
1
Earliest due date
2025-09-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040414001641 | O | Clinic/Group Practice | TX | 2025-09-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77515)
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