MEDICARE: COASTAL SURGICAL GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1699893503
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL SURGICAL GROUP

Provider Business Mailing Address
First Line	:	150 FM 1959 RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77034-5491
Country	:	US
Telephone Number	:	281-922-5550
Fax Number	:	281-481-8910

Provider Business Practice Location Address
First Line	:	150 FM 1959 RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77034-5491
Country	:	US
Telephone Number	:	281-922-5550
Fax Number	:	281-481-8910

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ANIBAL R. HADAD
Credential	:	MD
Telephone Number	:	281-922-5550

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	07/06/2010

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Directions to “COASTAL SURGICAL GROUP ” Practice Location

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