Coastal Wellness, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

801800621 Issued in TX

Legal business name

COASTAL WELLNESS, LLC

Practice address

9929 Spid Dr Ste 113
Corpus Christi, TX 78418-5164

Phone

(432) 889-5475

NPI assigned

Aug 29, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Shana Hisaw

Title

Owner

Phone

(432) 889-5475

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1377734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1447684097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9929 SPID DR STE 113",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784185164",
            "telephone_number": "432-889-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9929 SPID DR STE 113",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784185164",
            "telephone_number": "432-889-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-29",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "HISAW",
        "authorized_official_first_name": "SHANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "432-889-5475",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "801800621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Physician Group PA
• Coastal Physicians ER, PLLC
• Coastal Plains Hospital, LP
• Coastal Plains Hospital, LP
• Coastal Plains Hospital, LP
• Coastline Ambulance Service LLC (Coastline Ambulance Service)
• Coastline Ambulance Service, LLC (Coastline Ambulance)
• Jacquelyn Andrea Coates, PHYSICIAN ASSISTANT
• Mark Andrew Coates, P.A.
• Maria Izzabella Coats

• Professional Counselor in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.