Organization Active NPI

Coastal ER VII, LLC

  • Emergency Care Clinic/Center
  • San Antonio, TX
National Provider Identifier
1043762578
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
160288 Issued in TX
Legal business name
COASTAL ER VII, LLC
Practice address
3154 SE Military Dr Ste 103
San Antonio, TX 78223-3975
Phone
(210) 337-0911
Fax
(361) 884-1912
NPI assigned
Nov 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paul David Kenyon, MD
Title
LLC Board Member
Phone
(210) 337-0911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 160288 TX Primary

Addresses

Primary practice location

3154 SE Military Dr Ste 103
San Antonio, TX 78223-3975

Mailing address

PO Box 6327
Corpus Christi, TX 78466-6327
Phone (361) 884-2904

Other names 1

  • Physicians PremiER Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1043762578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6327",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784666327",
            "telephone_number": "361-884-2904",
            "fax_number": "361-884-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3154 SE MILITARY DR STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782233975",
            "telephone_number": "210-337-0911",
            "fax_number": "361-884-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ER VII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "KENYON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "LLC BOARD MEMBER",
        "authorized_official_telephone_number": "210-337-0911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "160288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physicians PremiER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.