Healthcare Provider Details

I. General information

NPI: 1770935975
Provider Name (Legal Business Name): GULF COAST PSYCHIATRIC HOSPITAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3126 RODD FIELD RD
CORPUS CHRISTI TX
78414-3901
US

IV. Provider business mailing address

3126 RODD FIELD RD
CORPUS CHRISTI TX
78414-3901
US

V. Phone/Fax

Practice location:
  • Phone: 361-452-6898
  • Fax: 361-452-6870
Mailing address:
  • Phone: 361-452-6898
  • Fax: 361-452-6870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: ABHISHEK SHARDA
Title or Position: BUSINESS DIRECTOR
Credential:
Phone: 361-452-6898