NPI 1033864236

Coastal Provider Providers LLC

Organisation Preferred Provider Organization Weslaco, TX

Practice location

Address: 448 S Texas Blvd, Weslaco, TX 78596-6201
Phone: (956) 520-8558
Fax: (956) 520-8557

Authorised official

Name: Lyza Elaine Garza-Gerow
Title: Owner
Phone: (956) 376-6851

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1033864236
Entity type: Organization
NPI issued: 16 Feb 2022
Record last updated: 16 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.