Coastal Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COASTAL FAMILY MEDICINE, LLC

Practice address

230 Parking Way St
Lake Jackson, TX 77566-5227

Phone

(979) 487-2135

Fax

(979) 341-0814

NPI assigned

Aug 30, 2018

Organization subpart

No

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

Authorized official

Name

Samantha Gonzalez, APRN

Title

Family Nurse Practitioner

Phone

(979) 487-2135

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546473600000",
    "number": "1831671445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 WILLOW CT",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775664718",
            "telephone_number": "979-824-8007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PARKING WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665227",
            "telephone_number": "979-487-2135",
            "fax_number": "979-341-0814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2019-01-03",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "979-487-2135",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adnan Chowdhury
• Christopher Morales
• Jennifer Michelle Cisneros, SLP
• Sandra Ann Clevenger
• CNM Homecare LLC
• Coastal Kids Therapy, PLLC
• Coburn Chiropractic Center
• Billy Bob Coburn, DC
• John Derek Cogdill, OT
• Kalyn Michelle Collard, MD

• Family Medicine Physician in Lake Jackson, TX
• Providers in Lake Jackson, 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 Jan 3, 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.