Organization
COASTAL BEND WELLNESS FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILL JERON HOELSCHER (CEO)
(361) 814-2001
Entity
Organization
Contact information
Practice address
5633 S STAPLES ST, SUITE 700, CORPUS CHRISTI, TX 78411-4646
(361) 814-2001
(361) 814-6502
Mailing address
5633 S STAPLES ST, SUITE 700, CORPUS CHRISTI, TX 78411-4646
(361) 814-2001
(361) 814-6502
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2918039
—
TX
01
—
383409
MEDICARE PTAN
TX
Enumeration date
04/10/2015
Last updated
04/10/2015
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