Coastal Bend Family Medicine, P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

H8480 Issued in TX

Legal business name

COASTAL BEND FAMILY MEDICINE, P.A.

Practice address

4818 Holly Rd
Suite a
Corpus Christi, TX 78411-4734

Phone

(361) 993-1747

Fax

(361) 993-1748

NPI assigned

Sep 9, 2005

Last updated

Mar 8, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Loyd Vanderheiden, D.O.NPI 1790779247

Title

President

Phone

(361) 993-1747

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Loyd Vanderheiden I, D.O.

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1790779247
  Medicare reassignment NPD Authorized official
• Erick Manuel Santos, MD

  • Orthopaedic Surgery Physician
  • Corpus Christi, TX
  • NPI 1679565071
  NPD

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488931200000",
    "number": "1629062179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4818 HOLLY RD",
            "address_2": "SUITE A",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114734",
            "telephone_number": "361-993-1747",
            "fax_number": "361-993-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4818 HOLLY RD",
            "address_2": "SUITE A",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784114734",
            "telephone_number": "361-993-1747",
            "fax_number": "361-993-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL BEND FAMILY MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-09",
        "last_updated": "2017-03-08",
        "status": "A",
        "authorized_official_last_name": "VANDERHEIDEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LOYD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "361-993-1747",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H8480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109485601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00K51Q",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "00K51Q",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Bend Counseling Associates
• Coastal Bend Emergency Services
• Coastal Bend Emergency Services Association
• Coastal Bend Eye Center
• Coastal Bend Family Chiropractic
• Coastal Bend Family Practice, PA
• Coastal Bend First Assistants LLC
• Coastal Bend Home Health LLC
• Coastal Bend House Calls
• Coastal Bend Internal Medicine PLLC (Coastal Bend Urgent Care and Walk In Clinic)

• Family Medicine Physician in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.