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Organization
COASTAL ER VII, LLC
Active
Organization
COASTAL ER VII, LLC
Active
Other names
Physicians PremiER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL DAVID KENYON MD (LLC BOARD MEMBER)
(210) 337-0911
Entity
Organization
Contact information
Practice address
3154 SE MILITARY DR STE 103, SAN ANTONIO, TX 78223-3975
(210) 337-0911
(361) 884-1912
Mailing address
PO BOX 6327, CORPUS CHRISTI, TX 78466-6327
(361) 884-2904
(361) 884-1912
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
160288
TX
Other
Enumeration date
11/01/2016
Last updated
11/01/2016
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