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

Active since November 01, 2006CLIA 45D1050607 · Accreditation
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: August 02, 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 holds an CLIA Accreditation certificate valid through December 18, 2026 and 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
Phone(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
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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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Accreditation 45D1050607

Gulf Coast Gastroenterology, PLLC · Lake Jackson, TX
Active · expires Dec 18, 2026
CLIA Number45D1050607
Laboratory TypePhysician Office
Certificate Effective DateDecember 19, 2024
Certificate Expiration DateDecember 18, 2026
Laboratory DirectorDr. Samuel M. Santala
Laboratory Phone(979) 297-4033
Laboratory LocationGulf Coast Gastroenterology, PLLC219 Oak Drive South, Suite A, Lake Jackson, TX 77566
CLIA data matches this NPI record on: Address Name Phone
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACALYN C SIVER P.A.-C
Physician Assistant
219 OAK DR S STE A
LAKE JACKSON, TX 77566
Brazoria County (979) 297-4033
DR. WILLIAM H SWEATT M.D.
Internal Medicine (Gastroenterology)
219 OAK DR S STE A
LAKE JACKSON, TX 77566
Brazoria County (979) 297-4033
RENAISSANCE LIBERTY PATHOLOGY,LLC
Clinical Medical Laboratory
219 OAK DR S STE A
LAKE JACKSON, TX 77566
Brazoria County (979) 297-4033
PRIMARY CARE ASSOCIATES OF LAKE JACKSON, PLLC
Physician Assistant
219 OAK DR S STE A
LAKE JACKSON, TX 77566
Brazoria County (979) 297-4033
MS. LISA MARIE SCHAUBROECK AGNP
Nurse Practitioner (Adult Health)
219 OAK DR S STE A
LAKE JACKSON, TX 77566
Brazoria County (979) 297-4033
TELEIOS ANESTHESIA PLLC
Anesthesiology
219 OAK DR S STE A
LAKE JACKSON, TX 77566
Brazoria County (979) 297-4033

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.

Does Gulf Coast Gastroenterology, PA hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 45D1050607) is associated with this NPI, valid through December 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 2 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.