| Coastal Home Medical Care Pllc | |
|
1504 Moreland Park Ct Friendswood TX 77546-1452 | |
| (281) 352-6612 | |
| Not Available |
| Full Name | Coastal Home Medical Care Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1504 Moreland Park Ct, Friendswood, Texas |
| Authorized Official Name and Position | Shebey Thomas (PHYSICIAN) |
| Authorized Official Contact | 2813526612 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Home Medical Care Pllc 1504 Moreland Park Ct Friendswood TX 77546-1452 Ph: (281) 352-6612 | Coastal Home Medical Care Pllc 1504 Moreland Park Ct Friendswood TX 77546-1452 Ph: (281) 352-6612 |
| NPI Number | 1538867262 |
|---|---|
| Provider Enumeration Date | 02/22/2023 |
| Last Update Date | 09/27/2024 |
| Medicare PECOS PAC ID | 6507224243 |
|---|---|
| Medicare Enrollment ID | O20230628000584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538867262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nidish Jose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104348903 PECOS PAC ID: 6507125713 Enrollment ID: I20180117000013 |
| Provider Name | Jennifer Nicole Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841937901 PECOS PAC ID: 2860871357 Enrollment ID: I20220613002354 |
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