Provider Demographics
NPI:1992380778
Name:COASTAL HEALTH CARE SYSTEMS, INC
Entity Type:Organization
Organization Name:COASTAL HEALTH CARE SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:INEGBEDION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-603-3773
Mailing Address - Street 1:23527 BAKER HILL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2569
Mailing Address - Country:US
Mailing Address - Phone:832-603-3773
Mailing Address - Fax:
Practice Address - Street 1:23527 BAKER HILL DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2569
Practice Address - Country:US
Practice Address - Phone:832-603-3773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-13
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX803956993OtherOFFICE OF THE SECRETARY OF STATE