COASTAL ER III, LLC (NPI# 1093191397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093191397 |
| Entity Type | Organization |
| Organization Name | COASTAL ER III, LLC |
| Other Organization Name | PHYSICIANS PREMIER EMERGENCY ROOM |
| Practice Address |
1860 Highway 181 Frontage Road Ste C Portland TX 78374 |
| Practice Telephone | 3619910912 |
| Mailing Telephone | 3619910912 |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2015-12-30 |
| Authorized Official Name | CHRISTOPHER KWON (MANAGER) |
| Authorized Official Telephone | 3619910912 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Physicians Premier Emergency Room | Doing Business As Name - Organization |
| Street Address |
1860 HIGHWAY 181 FRONTAGE ROAD STE C |
| City | PORTLAND |
| State | TX |
| Zip Code | 78374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700407350 | Emad Banoub | Pharmacist | 1105 Hyw 181, Portland, TX 78374 | 2020-05-05 |
| 1184256893 | Rebecca Lovins | Behavior Technician | 304, Frio Dr, Portland, TX 78374 | 2020-02-11 |
| 1760962997 | Kimberly Beal | Licensed Vocational Nurse | 201 Sabine St, Portland, TX 78374 | 2018-08-16 |
| 1134577836 | Christopher Tipton | Specialist/Technologist | 4800 Wildcat Dr., Portland, TX 78374 | 2016-06-03 |
| 1134592629 | Coastal Bend Physicians Pllc | Clinic/Center | 1860 Us Highway 181, Suite C, Portland, TX 78374 | 2015-11-05 |
| 1376942466 | Allen Portland Dentistry Associates Pllc | Dentist | 101 Cox Dr., Portland, TX 78374 | 2014-08-14 |
| 1699188284 | Leola Brumley | Speech-Language Pathologist | 2002 Matagorda Dr., Portland, TX 78374 | 2014-06-11 |
| 1780937607 | Erika Kristine De La Garza | Nurse Practitioner | 1702 Hwy. 181 North, Portland, TX 78374 | 2012-10-16 |
| 1538355219 | Andrew Marcus Rosendahl | Physician Assistant | 1912 Falcon Drive, Portland, TX 78374 | 2007-09-17 |
| 1821282583 | C H Wilkinson Physician Network | Nurse Practitioner | 1600 Wildcat Drive, Portland, TX 78374 | 2007-09-05 |
| Find all providers in zip 78374 | ||||
| Taxonomy Code | 261QE0002X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Emergency Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134592629 | Coastal Bend Physicians Pllc | Clinic/Center | 1860 Us Highway 181, Suite C, Portland, TX 78374 | 2015-11-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.