Organization
COASTAL PROVIDER PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYZA ELAINE GARZA-GEROW B.A (OWNER)
(956) 376-6851
Entity
Organization
Contact information
Practice address
448 S TEXAS BLVD, WESLACO, TX 78596-6201
(956) 520-8558
(956) 520-8557
Mailing address
448 S TEXAS BLVD, WESLACO, TX 78596-6201
(956) 520-8558
(956) 520-8557
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
02/16/2022
Last updated
02/16/2022
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