Organization
GULF COAST CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY ELIZABETH MONTALBANO (OFFICE MANAGER)
(409) 899-2300
Entity
Organization
Contact information
Practice address
2855 EASTEX FWY, SUITE E, BEAUMONT, TX 77706-3065
(409) 899-2300
(409) 898-2273
Mailing address
2855 EASTEX FWY, SUITE E, BEAUMONT, TX 77706-3065
(409) 899-2300
(409) 898-2273
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC4793
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120013101
—
TX
01
—
80V913
BLUE CROSS BLUE SHIELD
TX
01
—
8120051
BLUE LINK
TX
01
—
T20051
UPIN
TX
Enumeration date
10/25/2007
Last updated
09/02/2014
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