Provider Demographics
NPI:1033590633
Name:GULFCOAST MEDICAL HOUSECALLS, LLC
Entity type:Organization
Organization Name:GULFCOAST MEDICAL HOUSECALLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:GEROME
Authorized Official - Last Name:BARRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:303-913-2609
Mailing Address - Street 1:5529 FULLERTON CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80130-6649
Mailing Address - Country:US
Mailing Address - Phone:303-913-2609
Mailing Address - Fax:844-560-1060
Practice Address - Street 1:5529 FULLERTON CIR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80130-6649
Practice Address - Country:US
Practice Address - Phone:303-913-2609
Practice Address - Fax:844-560-1060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37001261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center