Provider Demographics
NPI:1740830959
Name:COASTAL PLAINS ENDEAVORS LLC
Entity type:Organization
Organization Name:COASTAL PLAINS ENDEAVORS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLOTTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-358-9200
Mailing Address - Street 1:1602 E HOUSTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-5335
Mailing Address - Country:US
Mailing Address - Phone:361-358-9200
Mailing Address - Fax:361-354-5714
Practice Address - Street 1:1602 E HOUSTON ST STE A
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-5335
Practice Address - Country:US
Practice Address - Phone:210-111-1111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-19
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty