Coastal Bend Retina, P.a.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

K3960 Issued in TX

Legal business name

COASTAL BEND RETINA, P.A.

Practice address

5934 S Staples St
Ste 214
Corpus Christi, TX 78413-3842

Phone

(361) 980-1115

Fax

(361) 980-3999

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sanjay Agarwal, M.D.NPI 1871575688

Title

President

Phone

(361) 980-1115

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 3

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

• Sanjay Agarwal, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Corpus Christi, TX
  • NPI 1871575688
  Medicare reassignment NPD Authorized official
• Rashed Alhabshan

  • Retina Specialist (Ophthalmology) Physician
  • Corpus Christi, TX
  • NPI 1811316680
  Medicare reassignment NPD
• Vamsi Krishna Gullapalli, MD, PHD

  • Ophthalmology Physician
  • Sartell, MN
  • NPI 1649477787
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1306962675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5934 S STAPLES ST",
            "address_2": "STE 214",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784133842",
            "telephone_number": "361-980-1115",
            "fax_number": "361-980-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5934 S STAPLES ST",
            "address_2": "STE 214",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784133842",
            "telephone_number": "361-980-1115",
            "fax_number": "361-980-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL BEND RETINA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-980-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "K3960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Bend Premier Solutions, LLC
• Coastal Bend Primary Care Corp
• Coastal Bend Prosthetics (Coastal Orthopedic Supply)
• Coastal Bend Psychiatric Associates P.a.
• Coastal Bend Psychological Associates
• Coastal Bend Speech and Language Associates
• Coastal Bend Surgery Center, LTD.
• Coastal Bend Wellness Foundation
• Coastal Bend Wellness Foundation Inc
• Coastal Bend Wellness Foundation Inc. (Coastal Bend Wellness Pharmacy)

• Ophthalmology Physician in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Ophthalmology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.