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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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