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General NPI Number Information
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NPI Number | 1902690597
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Entity Type | Organization
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Legal Business Name | SOUTH COAST ENDODONTICS
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Dates
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Enumeration Date | 04/08/2025
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 5525 S STAPLES ST STE A4
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-5362
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Country | US
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Telephone | 361-881-4260
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Fax | 361-881-4292
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Provider Business Mailing Address
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Address Line | 5525 S STAPLES ST STE A4
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City | CORPUS CHRISTI
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State | TX
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Zip | 78411-5362
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Country | US
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Telephone | 361-881-4260
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Fax | 361-881-4292
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Authorized Official
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Title or Position | MANAGER
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Name | MIROSLAVA RODRIGUEZ
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Credential |
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Telephone | 281-201-2824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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