Organization
JAIME D SANDOVAL M.D., P.A.
Active
Other names
Padre Coast Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
GINA BANUELOS (BILLING)
(361) 881-9300
Entity
Organization
Contact information
Practice address
1301 SANTA FE ST, SUITE B, CORPUS CHRISTI, TX 78404-2213
(361) 881-9300
(361) 881-8706
Mailing address
1301 SANTA FE ST, SUITE B, CORPUS CHRISTI, TX 78404-2213
(361) 881-9300
(361) 881-8706
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K1921
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
079775501
—
TX
Enumeration date
07/20/2006
Last updated
11/14/2013
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