1780022491 NPI number — TEXAS A&M HEALTH SCIENCE CENTER-COASTAL BEND HEALTH EDUCATION CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780022491 NPI number — TEXAS A&M HEALTH SCIENCE CENTER-COASTAL BEND HEALTH EDUCATION CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS A&M HEALTH SCIENCE CENTER-COASTAL BEND HEALTH EDUCATION CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COASTAL BEND HEALTH EDUCATION CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780022491
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/05/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6300 OCEAN DRIVE
Provider Second Line Business Mailing Address:
NRC 3500, UNIT 5861
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78412-5861
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-825-2804
Provider Business Mailing Address Fax Number:
361-825-2809

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4101 OLD BROWNSVILLE ROAD
Provider Second Line Business Practice Location Address:
HS1 BUILDING, SUITE 262
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-857-2945
Provider Business Practice Location Address Fax Number:
361-857-2963
Provider Enumeration Date:
06/05/2013

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
BARRY
Authorized Official Middle Name:
C
Authorized Official Title or Position:
VP FOR FINANCE & ADMINISTRATION
Authorized Official Telephone Number:
979-436-9202

Provider Taxonomy Codes

  • Taxonomy code: 133NN1002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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