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Organization

COASTAL ER III, LLC

Active
Other names
Physicians Premier Emergency Room
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTOPHER KWON M.D. (MANAGER)
(361) 991-0912
Entity
Organization

Contact information

Practice address
1860 HIGHWAY 181 FRONTAGE ROAD, STE C, PORTLAND, TX 78374
(361) 991-0912
Mailing address
PO BOX 6040, CORPUS CHRISTI, TX 78466-6040
(361) 723-0226
(512) 852-4625

Taxonomy

Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary

Other

Enumeration date
08/10/2015
Last updated
01/11/2024
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