Healthcare Provider Details

I. General information

NPI: 1730333543
Provider Name (Legal Business Name): DRISCOLL MATERNAL & FETAL PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2008
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7121 S PADRE ISLAND DR STE 118
CORPUS CHRISTI TX
78412-4946
US

IV. Provider business mailing address

PO BOX 9336
CORPUS CHRISTI TX
78469-9336
US

V. Phone/Fax

Practice location:
  • Phone: 361-980-1244
  • Fax: 361-980-1248
Mailing address:
  • Phone: 361-694-1603
  • Fax: 361-694-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DALE OBERMUELLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 361-694-5081