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

Table of content: (NPI 1780022491)

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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