NPIMap

Organization Active NPI

Coastal Bend Wellness Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Kingsville, TX
National Provider Identifier
1346907607
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COASTAL BEND WELLNESS FOUNDATION INC
Practice address
720 E Lee Ave
Kingsville, TX 78363-4606
Phone
(361) 290-7672
Fax
(877) 928-8238
NPI assigned
Nov 22, 2021
Organization subpart
No

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 13

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

View all 13

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231024002724 TX Part A Provider - Federally Qualified Health Center (FQHC) 9931422649 Practice locations: Kingsville, TX

Federally qualified health center certification: CCN 671144

Legal name
COASTAL BEND WELLNESS FOUNDATION INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 28, 2023
Last certification
Sep 28, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 27, 1986 in TX
Enrollment address
720 E Lee Ave
Kingsville, TX 78363-4606

All disclosed owners & managing parties 14

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Augustin Delagarza Individual Corporate OfficerCoo Dec 8, 2012
W-2 Managing EmployeeCoo Dec 8, 2012
Kelly L Bezio Individual Corporate DirectorBoard Member Apr 15, 2019
Kenneth Wood Individual Corporate OfficerBoard Chair Mar 15, 2020
Lee White Individual Corporate DirectorBoard Member Apr 15, 2019
Bill Jeron Hoelscher Individual Corporate OfficerCeo Mar 3, 2008
Liana Gonzales Individual Corporate DirectorVice Chair Apr 15, 2019
Mary Jane Hamilton Individual Corporate DirectorBoard Member Feb 1, 2017
Robin Carstensen Individual Corporate DirectorBoard Member Jun 15, 2020
Rolando Padilla Individual Corporate DirectorBoard Member Jul 1, 2019
Rodolfo Garcia Individual Corporate DirectorBoard Member Mar 15, 2021
Bonifacio Vega Individual Corporate DirectorVoluntary Board Member Feb 1, 2017
Sherdeana Owens Individual Corporate DirectorSecretary Apr 16, 2021
Francisco Morales Individual Corporate DirectorTreasurer Feb 1, 2018
Coastal Bend Wellness Foundation Inc Organization, Kingsville, TX Corporation, Non-profit Operational/Managerial Control Jun 1, 2021

National Provider Directory

National Provider Directory
Tax ID family
Coastal Bend Wellness4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Augustin Delagarza, MHA
Title
Coo
Phone
(361) 814-2001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

720 E Lee Ave
Kingsville, TX 78363-4606

Mailing address

2882 Holly Rd
Corpus Christi, TX 78415-4106
Phone (361) 814-2001

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1346907607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2882 HOLLY RD",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784154106",
            "telephone_number": "361-814-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E LEE AVE",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783634606",
            "telephone_number": "361-290-7672",
            "fax_number": "877-928-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL BEND WELLNESS FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "DELAGARZA",
        "authorized_official_first_name": "AUGUSTIN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "361-814-2001",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsville, TX

Sources for this page

Verify at the official NPI Registry.