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General NPI Number Information
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NPI Number | 1043299415
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Entity Type | Organization
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Legal Business Name | COASTAL BEND CANCER CENTER, PA
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1625 RODD FIELD RD SUITE 100
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City | CORPUS CHRISTI
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State | TX
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Zip | 78412-4926
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Country | US
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Telephone | 361-887-0067
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Fax | 361-887-1885
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Provider Business Mailing Address
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Address Line | PO BOX 81346
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City | CORPUS CHRISTI
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State | TX
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Zip | 78468-1346
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Country | US
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Telephone | 361-887-0067
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Fax | 361-887-1885
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. NORA RODRIGUEZ
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Credential |
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Telephone | 361-887-0067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | L5449
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K3846
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K1120
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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