1306922331 NPI number — US COAST GUARD SECTOR FIELD OFFICE GALVESTON HEALTH SERVICES DEPT

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 1306922331 NPI number — US COAST GUARD SECTOR FIELD OFFICE GALVESTON HEALTH SERVICES DEPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
US COAST GUARD SECTOR FIELD OFFICE GALVESTON HEALTH SERVICES DEPT
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:
Provider Other Organization Name Type Code:
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:
1306922331
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
U.S. COAST GUARD # 1 FERRY ROAD
Provider Second Line Business Mailing Address:
HEALTH SERVICES DIVISION
Provider Business Mailing Address City Name:
GALVESTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77553-1912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
409-766-4776
Provider Business Mailing Address Fax Number:
409-766-4765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
# 1 FERRY ROAD
Provider Second Line Business Practice Location Address:
HEALTH SERVICES DIVISION
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77553-1912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-766-4776
Provider Business Practice Location Address Fax Number:
409-766-4765
Provider Enumeration Date:
10/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NELSON
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
CLINIC ADMINISTRATOR
Authorized Official Telephone Number:
409-766-4776

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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