Individual
CECIL M BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1215 SANTA FE ST, CORPUS CHRISTI, TX 78404-2338
(361) 884-9900
(361) 884-9903
Mailing address
1215 SANTA FE ST, CORPUS CHRISTI, TX 78404-2338
(361) 884-9900
(361) 884-9903
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D8154
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
D8154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00823K
BLUE CROSS
TX
05
—
081210901
—
TX
01
—
110184080
MEDICARE RAILROAD
TX
01
—
82N381
BCBS
TX
Enumeration date
06/02/2005
Last updated
03/18/2016
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