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Organization

COASTAL PHYSICIANS REGIONAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL DAVID KENYON MD (LLC BOARD MEMBER)
(210) 337-0911
Entity
Organization

Contact information

Practice address
3154 SE MILITARY DR STE 103, SAN ANTONIO, TX 78223-3975
(210) 337-0911
Mailing address
PO BOX 6327, CORPUS CHRISTI, TX 78466-6327
(210) 337-0911

Taxonomy

Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
160288
TX

Other

Enumeration date
11/02/2016
Last updated
11/02/2016
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