| Coastal Medical Clinic | |
|
1704 Jenkins St Rockport TX 78382-3341 | |
| (361) 790-9047 | |
| (361) 790-9615 |
| Full Name | Coastal Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1704 Jenkins St, Rockport, Texas |
| Authorized Official Name and Position | Randy D. Bingham (OWNER PROVIDER) |
| Authorized Official Contact | 3617909047 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Medical Clinic 1704 Jenkins St Rockport TX 78382-3341 Ph: (361) 790-9047 | Coastal Medical Clinic 1704 Jenkins St Rockport TX 78382-3341 Ph: (361) 790-9047 |
| NPI Number | 1780869065 |
|---|---|
| Provider Enumeration Date | 01/04/2008 |
| Last Update Date | 12/06/2022 |
| Medicare PECOS PAC ID | 9436232162 |
|---|---|
| Medicare Enrollment ID | O20080218000723 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780869065 | NPI | - | NPPES |
| 0082RB | Other | TX | BLUE CROSS |
| 196052801 | Medicaid | TX | |
| 196052802 | Other | TX | MEDICAID # FOR RURAL HEALTH CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (Texas) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | 673904 (Texas) | Primary |
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