Coastal Mobile Medical Group, PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

COASTAL MOBILE MEDICAL GROUP, PLLC

Practice address

10825 Basal Edge Rd
Helotes, TX 78023-5109

Phone

(210) 867-9563

NPI assigned

Aug 30, 2019

Organization subpart

No

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

Authorized official

Name

Ron Guevara, DO

Title

President/Owner

Phone

(361) 728-5907

Specialties & licenses 1

Addresses

Practitioners 1

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

• Cesar Iglesias, PA-C

  • Physician Assistant
  • Jbsa Lackland, TX
  • NPI 1720315237
  NPD (past)

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

{
    "created_epoch": "1567123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1699323873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10825 BASAL EDGE RD",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780235109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 BASAL EDGE RD",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780235109",
            "telephone_number": "210-867-9563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MOBILE MEDICAL GROUP, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-30",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "GUEVARA",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "361-728-5907",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shameelah Chambliss, LCSW
• Alexandra Chapa
• Christopher Garcia
• City of Helotes
• Cja Surgical Assistants
• Kaci Jolynn Contreras
• Katie Amanda Corkill
• Sierra Coronado
• Nicholas Andrew Coronel, DDS
• Tracie Correa, DDS

• General Practice Physician in Helotes, TX
• Providers in Helotes, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; 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.