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Organization
COASTAL BEND AMBULATORY SURGICAL CENTER INC.
Active
Organization
COASTAL BEND AMBULATORY SURGICAL CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB JACKSON MOORE MD (PRESIDENT/MEDICAL DIRECTOR)
(361) 888-4288
Entity
Organization
Contact information
Practice address
900 MORGAN AVE, CORPUS CHRISTI, TX 78404-2028
(361) 888-4288
(361) 888-4786
Mailing address
PO BOX 3827, CORPUS CHRISTI, TX 78463-3827
(361) 888-4288
(361) 888-4786
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
000147
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085872201
—
TX
01
—
490000435
MEDICARE- RAILROAD
TX
01
—
HH1251
BLUE CROSS/BLUE SHIELD
TN
Enumeration date
07/22/2006
Last updated
09/02/2022
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