Organization
COLON AND RECTAL ASSOCIATES OF SOUTH TEXAS
Active
Organization
COLON AND RECTAL ASSOCIATES OF SOUTH TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL LYNN MICAN (PRACTICE MANAGER)
(361) 883-3831
Entity
Organization
Contact information
Practice address
613 ELIZABETH ST STE 809, CORPUS CHRISTI, TX 78404-2232
(361) 883-3831
(361) 887-0146
Mailing address
613 ELIZABETH ST STE 809, CORPUS CHRISTI, TX 78404-2232
(361) 883-3831
(361) 887-0146
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
E7836
TX
208C00000X
Colon & Rectal Surgery Physician
Primary
G9395
TX
208C00000X
Colon & Rectal Surgery Physician
M0423
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101550502
—
TX
05
—
114250703
—
TX
05
—
172277901
—
TX
Enumeration date
03/29/2007
Last updated
01/03/2024
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