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General NPI Number Information
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NPI Number | 1710071543
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Entity Type | Organization
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Legal Business Name | COASTAL BEND SURGERY CENTER, LTD.
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 5837 SPOHN DR
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-4121
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Country | US
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Telephone | 361-993-2000
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Fax | 361-985-6834
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Provider Business Mailing Address
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Address Line | 6130 PARKWAY DRIVE
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City | CORPUS CHRISTI
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State | TX
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Zip | 78414-4121
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Country | US
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Telephone | 361-993-2000
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Fax | 361-985-6834
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Authorized Official
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Title or Position | CFO
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Name | MRS. NICOLE MORALES
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Credential |
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Telephone | 361-993-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 008062
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License Number State | TX
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