Organization
CECIL M. BOURNE, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CECIL MARTINDALE BOURNE MD, FACP (OWNER)
(361) 852-4200
Entity
Organization
Contact information
Practice address
3301 S ALAMEDA ST, SUITE 306, CORPUS CHRISTI, TX 78411-1882
(361) 852-4200
(361) 852-5304
Mailing address
3301 S ALAMEDA ST, SUITE 306, CORPUS CHRISTI, TX 78411-1882
(361) 852-4200
(361) 852-5304
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D8154
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081210901
—
TX
01
—
110184080
MEDICARE RAILROAD
TX
01
—
82N381
BCBS
—
Enumeration date
10/29/2007
Last updated
10/26/2010
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