Provider Demographics
NPI:1427635804
Name:MID COAST MEDICAL CENTER-CENTRAL
Entity type:Organization
Organization Name:MID COAST MEDICAL CENTER-CENTRAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-569-7370
Mailing Address - Street 1:305 SANDY CORNER RD
Mailing Address - Street 2:
Mailing Address - City:EL CAMPO
Mailing Address - State:TX
Mailing Address - Zip Code:77437-9535
Mailing Address - Country:US
Mailing Address - Phone:979-543-5510
Mailing Address - Fax:
Practice Address - Street 1:308 RANCH ROAD 2900
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:TX
Practice Address - Zip Code:78639-6063
Practice Address - Country:US
Practice Address - Phone:979-543-5510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty