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NPI Code Detail

MEDICARE: SHORELINE SURGERY CENTER LLP

MEDICARE: SHORELINE SURGERY CENTER LLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center008393TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00465833OTHERTXMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HH1218OTHERTXBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730369802
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHORELINE SURGERY CENTER LLP
Provider Business Mailing Address
First Line : 718 ELIZABETH ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78404-2212
Country : US
Telephone Number : 361-882-3204
Fax Number : 361-886-6322
Provider Business Practice Location Address
First Line : 718 ELIZABETH ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78404-2212
Country : US
Telephone Number : 361-882-3204
Fax Number : 361-886-6322
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : PETER BLACH
Credential :
Telephone Number : 713-343-9083
Provider Enumeration Date : 11/06/2007
Last Update Date : 01/11/2025

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Directions to “SHORELINE SURGERY CENTER LLP ” Practice Location

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