Provider Demographics
NPI:1306922331
Name:US COAST GUARD SECTOR FIELD OFFICE GALVESTON HEALTH SERVICES DEPT
Entity type:Organization
Organization Name:US COAST GUARD SECTOR FIELD OFFICE GALVESTON HEALTH SERVICES DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-766-4776
Mailing Address - Street 1:U.S. COAST GUARD # 1 FERRY ROAD
Mailing Address - Street 2:HEALTH SERVICES DIVISION
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77553-1912
Mailing Address - Country:US
Mailing Address - Phone:409-766-4776
Mailing Address - Fax:409-766-4765
Practice Address - Street 1:# 1 FERRY ROAD
Practice Address - Street 2:HEALTH SERVICES DIVISION
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77553-1912
Practice Address - Country:US
Practice Address - Phone:409-766-4776
Practice Address - Fax:409-766-4765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center