GULF COAST GASTROENTEROLOGY, PA
NPI 1104904077
Internal Medicine - Gastroenterology in Lake Jackson, TX

Active since November 01, 2006
219 OAK DR S STE A, LAKE JACKSON, TX 77566(979) 297-4033(979) 297-4099 Get Directions Write a Review

NPPES record last updated: September 18, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Gulf Coast Gastroenterology, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GULF COAST GASTROENTEROLOGY, PA (NPI 1104904077) is a healthcare organization registered as a gastroenterology in Lake Jackson, Texas and active in the NPI registry since November 2006. The organization lists Britiany Bush, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1104904077
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameGULF COAST GASTROENTEROLOGY, PA
Location Address219 OAK DR S STE ALake Jackson, TX 77566-5675
Mailing Address104 Circle Way St Ste BLake Jackson, TX 77566-5200 · (979) 297-4033
Fax(979) 297-4099
Organization SubpartNo
Authorized OfficialBritiany BushOffice Manager · (979) 297-4033
Enumeration DateNovember 1, 2006
Last NPPES UpdateSeptember 18, 2023
NPPES CertifiedSeptember 18, 2023
✔ NPI 1104904077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
219 OAK DR S STE A, Lake Jackson, TX 77566

Other Identifiers 1

Medicaid181777701TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gulf Coast Gastroenterology, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Gulf Coast Gastroenterology, PA, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Gastroenterology
NPI 1255330445
219 OAK DR S STE A
Lake Jackson, TX 77566
(979) 297-4033
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1982366209
4301 VISTA RD
Pasadena, TX 77504
(713) 378-3000
✔ PECOS✔ Accepts Medicare45 mi
Nurse Practitioner
NPI 1306100433
915 GESSNER RD STE 360
Houston, TX 77024
(713) 468-5440
✔ PECOS✔ Accepts Medicare51 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gulf Coast Gastroenterology, PA's NPI number?

The NPI number for Gulf Coast Gastroenterology, PA is 1104904077. It was assigned to this organization in the NPPES registry on November 1, 2006.

Where is Gulf Coast Gastroenterology, PA located?

Gulf Coast Gastroenterology, PA is located at 219 Oak Dr S Ste A, Lake Jackson, TX 77566. The listed phone number is (979) 297-4033.

What is Gulf Coast Gastroenterology, PA's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Gulf Coast Gastroenterology, PA enrolled in Medicare?

Yes. Gulf Coast Gastroenterology, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gulf Coast Gastroenterology, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Gulf Coast Gastroenterology, PA, in Gastroenterology and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Gulf Coast Gastroenterology, PA was last updated on September 18, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.