Provider Demographics
NPI:1033398813
Name:COASTAL BEND PSYCHIATRIC ASSOCIATES P.A.
Entity Type:Organization
Organization Name:COASTAL BEND PSYCHIATRIC ASSOCIATES P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:R
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-993-8358
Mailing Address - Street 1:6625 WOOLDRIDGE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2916
Mailing Address - Country:US
Mailing Address - Phone:361-993-8358
Mailing Address - Fax:361-993-8874
Practice Address - Street 1:6625 WOOLDRIDGE RD
Practice Address - Street 2:STE 201
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2916
Practice Address - Country:US
Practice Address - Phone:361-993-8358
Practice Address - Fax:361-993-8874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG90912084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U43ZMedicare PIN