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General NPI Number Information
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NPI Number | 1407082597
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Entity Type | Organization
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Legal Business Name | COASTAL BEND ORTHOPEDICS SUPPLY, INC.
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 07/08/2010
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Provider Practice Location Address
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Address Line | 301 N KING ST
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City | ALICE
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State | TX
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Zip | 78332-4761
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Country | US
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Telephone | 361-668-8500
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Fax | 361-668-8503
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Provider Business Mailing Address
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Address Line | PO BOX 1460
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City | ALICE
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State | TX
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Zip | 78333-1460
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Country | US
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Telephone | 361-668-8500
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Fax | 361-668-8503
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESUS E GARCIA
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Credential |
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Telephone | 361-668-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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