Organization
COASTAL ER I, LLC
Active
Other names
Physicians Premier Emergency Room
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER KWON MD (LLC BOARD MEMBER)
(361) 980-0911
Entity
Organization
Contact information
Practice address
5521 SARATOGA BLVD, STE 100, CORPUS CHRISTI, TX 78413-2843
(361) 980-0911
(361) 980-1459
Mailing address
PO BOX 6040, CORPUS CHRISTI, TX 78466-6040
(361) 723-0226
(512) 852-4625
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160125
TDSHS FSEC LICENSE
TX
Enumeration date
06/03/2014
Last updated
01/11/2024
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