SOUTH COAST HEALTH CARE OF TEXAS, PA – General Practice Physician, NPI 1508882036
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SOUTH COAST HEALTH CARE OF TEXAS, PA
1908 N LAURENT ST STE 410
VICTORIA, TX 779015469
Phone: (361) 572-0333
Fax: (361) 572-8518
Type: Mailing
2700 CITIZENS PLZ STE 100
VICTORIA, TX 779015756
Phone: (361) 579-1371
Fax: (361) 579-1373
Type: Location
Box Place, Cambridge, Hoppers Crossing, Melbourne, Victoria, 3029, Australia
VICTORIA, TX 779034045
Phone: (361) 572-0333
Fax: (361) 572-8518
Type: Mailing
East San Antonio Street, Victoria, Victoria County, Texas, 77901, United States
SUITE 203 W
VICTORIA, TX 779016004
Phone: (361) 572-0333
Fax: (361) 572-8518
Type: Location
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: 2005-03-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-03-31 (69 days ago).
Enrollment records
1
Earliest due date
2026-03-31
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 |
|---|---|---|---|---|
| O20050328000820 | O | Clinic/Group Practice | TX | 2026-03-31 |
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 77901)
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