Provider Demographics
NPI:1801319983
Name:COASTAL ER VIII, LLC
Entity type:Organization
Organization Name:COASTAL ER VIII, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LLC MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWIRTLICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-438-6911
Mailing Address - Street 1:PO BOX 6844
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6844
Mailing Address - Country:US
Mailing Address - Phone:361-884-2904
Mailing Address - Fax:512-852-4625
Practice Address - Street 1:20475 HIGHWAY 46 W STE 100
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6147
Practice Address - Country:US
Practice Address - Phone:830-438-6911
Practice Address - Fax:512-852-4625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-20
Last Update Date:2017-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care