Provider Demographics
NPI:1508448671
Name:BAYSIDE PULMONOLOGY PLLC
Entity Type:Organization
Organization Name:BAYSIDE PULMONOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARROQUIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-885-7722
Mailing Address - Street 1:PO BOX 3866
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78463-3866
Mailing Address - Country:US
Mailing Address - Phone:361-885-7722
Mailing Address - Fax:361-885-7792
Practice Address - Street 1:3302 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1821
Practice Address - Country:US
Practice Address - Phone:361-885-7722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty