| Coastal Bend Wellness Foundation Inc | |
|
720 E Lee Ave Kingsville TX 78363-4606 | |
| (361) 290-7672 | |
| (877) 928-8238 |
| Full Name | Coastal Bend Wellness Foundation Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 720 E Lee Ave, Kingsville, Texas |
| Authorized Official Name and Position | Augustin Delagarza (COO) |
| Authorized Official Contact | 3618142001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Bend Wellness Foundation Inc 2882 Holly Rd Corpus Christi TX 78415-4106 Ph: (361) 814-2001 | Coastal Bend Wellness Foundation Inc 720 E Lee Ave Kingsville TX 78363-4606 Ph: (361) 290-7672 |
| NPI Number | 1346907607 |
|---|---|
| Provider Enumeration Date | 11/22/2021 |
| Last Update Date | 11/22/2021 |
| Medicare PECOS PAC ID | 9931422649 |
|---|---|
| Medicare Enrollment ID | O20231024002724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346907607 | NPI | - | NPPES |
| PENDING | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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