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Organization

COASTAL VASCULAR & VEIN CENTER, LLC

Active
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Organization

COASTAL VASCULAR & VEIN CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JARYD STEIN (CMO)
(214) 392-4976
Entity
Organization

Contact information

Practice address
1327 ASHLEY RIVER RD, CHARLESTON, SC 29407-5384
(843) 577-4551
(843) 577-2227
Mailing address
8135 FOREST LN # 515057, DALLAS, TX 75230-2472
(843) 577-4551
(843) 577-2227

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
SC
335E00000X
Prosthetic/Orthotic Supplier
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0489056
AETNA
SC
01
—
610303400
U S DEPARTMENT OF LABOR
SC
05
—
PA1729
—
SC
Enumeration date
02/05/2007
Last updated
09/01/2026
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