Organization
COASTAL FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA GONZALEZ APRN (FAMILY NURSE PRACTITIONER)
(979) 487-2135
Entity
Organization
Contact information
Practice address
230 PARKING WAY ST, LAKE JACKSON, TX 77566-5227
(979) 487-2135
(979) 341-0814
Mailing address
52 WILLOW CT, LAKE JACKSON, TX 77566-4718
(979) 824-8007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/30/2018
Last updated
01/03/2019
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