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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