Healthcare Provider Details

I. General information

NPI: 1255324851
Provider Name (Legal Business Name): COASTAL CARDIOLOGY ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 TEXAN TRL STE 300
CORPUS CHRISTI TX
78411-2549
US

IV. Provider business mailing address

601 TEXAN TRL STE 300
CORPUS CHRISTI TX
78411-2549
US

V. Phone/Fax

Practice location:
  • Phone: 361-887-2900
  • Fax:
Mailing address:
  • Phone: 361-887-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSEMARY LOZANO
Title or Position: ADMINISTRATOR
Credential:
Phone: 361-887-2739