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General NPI Number Information
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NPI Number | 1003627712
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Entity Type | Organization
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Legal Business Name | MID COAST MEDICAL CENTER - TRINITY
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 315 PROSPECT DR
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City | TRINITY
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State | TX
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Zip | 75862-6202
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Country | US
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Telephone | 936-744-1400
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Fax | 817-231-0367
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Provider Business Mailing Address
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Address Line | 303 SANDY CORNER RD
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City | EL CAMPO
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State | TX
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Zip | 77437-9844
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Country | US
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Telephone | 979-543-6251
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DAVID H MAK
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Credential |
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Telephone | 713-569-7370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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