Provider Demographics
NPI:1740312370
Name:COASTAL ORTHOPEDICS, P.A.
Entity type:Organization
Organization Name:COASTAL ORTHOPEDICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-994-1166
Mailing Address - Street 1:5920 SARATOGA BLVD
Mailing Address - Street 2:SUITE 600A
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4103
Mailing Address - Country:US
Mailing Address - Phone:361-994-1166
Mailing Address - Fax:361-994-7046
Practice Address - Street 1:5920 SARATOGA BLVD
Practice Address - Street 2:SUITE 600A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4103
Practice Address - Country:US
Practice Address - Phone:361-994-1166
Practice Address - Fax:361-994-7046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00360UOtherMEDICARE GROUP PROVIDER NUMBER