| NPI | 1689267783 |
|---|---|
| Doing Business As | SHINE FOOT AND ANKLE CENTER, PRIVIA MEDICAL GROUP GULF COAST, PLLC |
| Entity Type | Organization |
| Authorized Contact | BARBARA JORDAN Associate VP, Revenue Cycle 713-512-7613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2021-02-19 |